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Cited by 107Cardiac electrophysiology and arrhythmiasDiabetes Management and ResearchPancreatic function and diabetes

Electrocardiographic Alterations during Hyperinsulinemic Hypoglycemia in Healthy Subjects

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Laitinen, Tomi, Lyyra‐Laitinen, Tiina, Huopio, Hanna, Vauhkonen, Ilkka, Halonen, Toivo, Hartikainen, Juha, Niskanen, Leo, Laakso, Markku·2008·Annals of Noninvasive Electrocardiology
DOI 10.1111/j.1542-474x.2008.00208.xPMC PMC6931981
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Abstract

Background: We evaluated the arrhythmogenic potential of hypoglycemia by studying electrocardiographic (ECG) changes in response to hyperinsulinemic hypoglycemia and associated sympathoadrenal counterregulatory responses in healthy subjects. Methods: The study population consisted of 18 subjects, aged 30–40 years. Five‐minute ECG recordings and blood samplings were performed at baseline and during the euglycemic and hypoglycemic hyperinsulinemic clamp studies. PR, QT, and QTc intervals of electrocardiogram and ECG morphology were assessed from signal‐averaged ECG. Results: Although cardiac beat interval remained unchanged, PR interval decreased (P < 0.01) and QTc interval (P < 0.001) increased in response to hyperinsulinemic hypoglycemia. Concomitant morphological alterations consisted of slight increases in R‐wave amplitude and area (P < 0.01 for both), significant decreases in T‐wave amplitude and area (P < 0.001 for both), and moderate ST depression (P < 0.001). Counterregulatory norepinephrine response correlated with amplification of the R wave (r =−0.620, P < 0.05) and epinephrine response correlated with flattening of the T wave (r =−0.508, P < 0.05). Conclusions: Hyperinsulinemic hypoglycemia with consequent sympathetic humoral activation is associated with several ECG alterations in atrioventricular conduction, ventricular depolarization, and ventricular repolarization. Such alterations in cardiac electrical function may be of importance in provoking severe arrhythmias and “dead‐in‐bed” syndrome in diabetic patients with unrecognized hypoglycemic episodes.

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  • Alterations in PR interval, T-wave amplitude and area, and QTc during induced hypoglycemia may be of importance in provoking severe arrhythmia in diabetic patients.

    “alterations that may be of importance in provoking severe arrhythmia in diabetic patients.23”

    From The Year of 2008 in Electrocardiology (2010) · cites this paper as [23]

  • Induced hypoglycemia in healthy subjects is associated with a significantly decreased PR interval and T-wave amplitude and area and increased QTc interval.

    “Induced hypoglycemia in healthy subjects was associated with a significantly decreased PR interval and T-wave amplitude and area and increased QTc interval, alterations that may be of importance in provoking severe arrhythmia in diabetic patients.23”

    From The Year of 2008 in Electrocardiology (2010) · cites this paper as [23]

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Authors
Laitinen, T., Lyyra‐Laitinen, T., Huopio, H., Vauhkonen, I., Halonen, T., Hartikainen, J., Niskanen, L., & Laakso, M.
Affiliations
Kuopio University Hospital (FI)
ORCID
Venue
Annals of Noninvasive Electrocardiology
Publisher
Wiley
Published
2008-04
Volume
13
Issue
2
Pages
97-105
ISSN
  • 1082-720X (ISSN-L)
  • 1542-474X
DOI
10.1111/j.1542-474x.2008.00208.x
PMC
PMC6931981
OpenAlex
W1849745725
Cited by
107
References
31
Citations by year
2025: 4 · 2024: 10 · 2023: 6 · 2022: 8 · 2021: 5 · 2020: 7 · 2019: 4 · 2018: 6 · 2017: 4 · 2016: 5 · 2015: 4 · 2014: 7 · 2013: 8 · 2012: 2
FWCI
6.55
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 17 d)
Locations
  • Annals of Noninvasive Electrocardiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Kuopion Yliopistollinen Sairaala
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Keywords
hyperinsulinemic hypoglycemia, electrocardiographic changes, QTc interval, PR interval, signal-averaged electrocardiogram, norepinephrine, epinephrine, arrhythmogenesis, diabetic hypoglycemia, ventricular repolarization, atrioventricular conduction
MeSH terms
Adult, Analysis of Variance, Electrocardiography, Female, Glucose, Heart Conduction System, Humans, Hyperinsulinism, Hypoglycemia, Infusions, Intravenous, Insulin, Male, Probability, Reference Values, Glucose Clamp Technique, Cohort Studies, Statistics, Nonparametric

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