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Titolo:
Reassessing the role of QT(c) in the diagnosis of autonomic failure among patients with diabetes - A meta-analysis
Autore:
Whitsel, EA; Boyko, EJ; Siscovick, DS;
Indirizzi:
Vet Affairs Puget Sound Hlth Care Syst, NW Ctr Outcomes Res Older Adults, Seattle, WA 98108 USA Vet Affairs Puget Sound Hlth Care Syst Seattle WA USA 98108 WA 98108 USA Vet Affairs Puget Sound Hlth Care Syst, Seattle Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA Vet Affairs Puget Sound Hlth Care Syst Seattle WA USA 98108 WA 98108 USA Univ Washington, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Hlth Res Unit, Seattle, WA 98195 USA Univ Washington, Dept Med & Epidemiol, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 d & Epidemiol, Seattle, WA 98195 USA
Titolo Testata:
DIABETES CARE
fascicolo: 2, volume: 23, anno: 2000,
pagine: 241 - 247
SICI:
0149-5992(200002)23:2<241:RTROQI>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
QT INTERVAL PROLONGATION; Q-T INTERVAL; NERVOUS-SYSTEM; NEUROPATHY; MELLITUS; TESTS; ELECTROCARDIOGRAM; METAANALYSIS; ASSOCIATION; PROPRANOLOL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
48
Recensione:
Indirizzi per estratti:
Indirizzo: Whitsel, EA Vet Affairs Puget Sound Hlth Care Syst, NW Ctr Outcomes Res Older Adults, 1660 S Columbian Way, Seattle, WA 98108 USA Vet Affairs Puget Sound Hlth Care Syst 1660 S Columbian Way Seattle WA USA 98108
Citazione:
E.A. Whitsel et al., "Reassessing the role of QT(c) in the diagnosis of autonomic failure among patients with diabetes - A meta-analysis", DIABET CARE, 23(2), 2000, pp. 241-247

Abstract

OBJECTIVE- A 1992 consensus statement on autonomic testing portrayed Bazett's heart race-corrected QT interval (QT(c)) prolongation as a specific yetinsensitive indicator of diabetic autonomic failure. At that time, only a few small studies had evaluated the accuracy of QT(c). To date, even fewer studies have evaluated whether its accuracy is influenced by patient characteristics. RESEARCH DESIGN AND METHODS - We critically appraised 17 studies reportingthe sensitivity and specificity of QT(c) for diabetic autonomic failure. The studies represented 4,584 patients with diabetes (mean age 34.9 years, 46% female, 92% with type 1 diabetes, mean duration of diabetes 14.5 years). We summarized the accuracy of QT(c) prolongation for diabetic autonomic failure as an odds ratio (OR) (95% CI) and determined whether patient and study design characteristics influenced the accuracy of QT(c) prolongation by comparing summary receiver operating characteristic curves. RESULTS - Autonomic failure, defined as greater than or equal to 1.2 +/- 0.4 (mean +/- SD) abnormal of 2.0 +/- 1.6 administered cardiovascular reflextests, was found in 26% (25-28) of patients. The pooled sensitivity and specificity of QT(c) > 441 +/- 8 ms for autonomic failure were 28% (26-29) and 86% (85-87), respectively. Autonomic failure was 2.26 times (1.90-2.70) more likely to be present in patients with than in patients without QT(c) prolongation. At 86% specificity the sensitivity of QT(c) prolongation was 46vs. 12% for men versus women (P = 0.0077), respectively, and, after adjustment for sex, 66 vs. 17% among patients aged 25 vs. 55 years (P = 0.1902) and 61 vs. 27% at thresholds of >420 vs. >460 ms, respectively (P = 0.2964). CONCLUSIONS - QT(c) prolongation is a specific albeit insensitive indicator of autonomic failure. Although QT(c) prolongation is relatively accurate for men, accuracy may be even greater for young men at low QT(c) thresholds.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 15:16:49