The impotance of ventricular repolarization parameters in the evaluation of the risk of sudden cardiac death in diabetic patients with moderate systolic heart failure

Purpose: ICD implantation is recommended to prevent sudden cardiac death in ischemic heart failure patients with left ventricular ejection fraction (LVEF)<35. In the studies carried out, sudden cardiac death rates were found to be higher in diabetic ischemic heart failure patients with LVEF between 35-49% compared to patients without diabetes. In this group, independent predictors other than LVEF are needed. The study aimed to evaluate ventricular repolarization parameters in predicting the risk of sudden cardiac death in diabetic patients followed up with ischemic heart failure with LVEF between 35-49% after MI. Method: Diabetic and non-diabetic patients with LVEF between 35-49% after ACS were included in the study at Karadeniz Technical University Medical Faculty Hospital between 2012 and 2020. A sum of 666 patients was included in the study, including 285 diabetic patients and 381 non-diabetic patients, and the average follow-up period was 45 months. The ECGs of the patients were examined before discharge. Tpe interval and Tpe/QT ratios and mortality rates between both groups were compared. Findings: As a result of our study, the Tpe interval were found to be longer and Tpe/QT ratio were found to be higher in the diabetic patient group (mean Tpe value 90.5±15.6 ms p<0.001; mean Tpe/QT value 0.223±0.033 p<0.001). There was no significant difference in all-cause mortality between the diabetic patient group and the non-diabetic patient group (p=0.586). The rate of sudden cardiac death in diabetic patients was significantly higher than in the non-diabetic group (p=0.037). Conclusion: Diabetes was a predictor of sudden cardiac death in patients followed up with EF between 35-49% after myocardial infarction, and Tpe interval and Tpe/QT ratio were found to be significantly higher in the diabetic group with higher specificity and sensitivity.