T Wave and QRS Complex Alternans During Stress ECG Testing According to the Presence or Absence of Diabetes Mellitus

Ivaylo Christov, Giovanni Bortolan, Iana Simova, Tzvetana Katova


Background: Diabetes mellitus (DM) is a well recognised cardiovascular risk factor, associated with adverse clinical outcomes. Microvolt T wave alternans (TWA) and to some extent alternans of the QRS complex (QRSA) during stress ECG testing have the ability to detect patients at an increased risk for sudden cardiac death (SCD). The results about the influence of DM on TWA during stress testing are controversial, and studies regarding QRSA values during stress ECG testing according to the presence or absence of DM are lacking. The purpose of the present study is to evaluate the influence of DM on TWA and QRSA during stress ECG testing.

Methods: Principal component analysis, combined with wave amplitude computation was used for TWA and QRSA quantification. We studied 107 patients (63 10 years, 42% male). DM was present in 36% and angiographically significant coronary artery disease (AS-CAD) in 45%.

Results: Patients with DM had higher QRSA compared to non-diabetics (P = 0.001); TWA did not differ significantly. Patients with positive stress ECG tests had higher TWA and QRSA compared to those with negative stress tests (P less than 0.001), no matter of the presence or absence of DM. In non-diabetics TWA and QRSA values were significantly higher when percutaneous coronary intervention (PCI) was performed (P less than or equal to 0.001), while in the diabetic subgroup such a difference was attenuated to no significant.

Conclusions: Diabetics had higher QRSA during stress ECG testing, while TWA values were not significantly influenced by the diabetic status. The presence of DM attenuates the observed differences of TWA and QRSA between patients with or without PCI.

J Endocrinol Metab. 2012;2(1):32-38
doi: https://doi.org/10.4021/jem69e


T wave alternans; QRS complex alternans; Stress ECG testing; Diabetes mellitus 

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Endocrinology and Metabolism, bimonthly, ISSN 1923-2861 (print), 1923-287X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.jofem.org   editorial contact: editor@jofem.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.