Analysis of T wave morphology in the phase space on single-channel electrocardiogram in children with type 1 diabetes mellitus
Background. Cardiovascular disorders in children with type 1 diabetes mellitus (DM 1) are the main cause of mortality in adult patients and play a major role in the development of sudden cardiac death. The purpose of the research was to study additional markers of myocardial dysfunction in children with DM 1 by analyzing a single-channel electrocardiogram in the phase space. Materials and methods. The main group consisted of 83 patients aged 4–16 years with DM 1, control group — 95 healthy schoolchildren aged 12–16 years. The traditional and original electrocardiography (ECG) parameters of the first standard lead were studied and automatically calculated using the Fazagraf® system. ECG recording was carried out in a sitting position in a state of relative calm. Results. In children with DM 1, unlike their healthy peers, a typical pattern of traditional ECG is formed, with high and wide P wave, long QTc, flattened and narrow T wave. An increase in the parameter of square deviation of T wave symmetry (SD βT) was found in 68.7 % of children with DM 1 and in only 30.5 % of healthy schoolchildren. SD βT significantly increases with the duration of DM 1 in children. The group at high risk for the development of cardiovascular complications consists of children with DM duration of 3–5 years. Suboptimal glycemic control and high-risk control greatly increase the instability of myocardial function. Conclusions. An increase in the SD βT parameter can be used as a marker of heart lesion in children with DM 1. Early and systematic examination with further analysis of ECG in the phase space and optimal glycemic control can reduce the level of chronic cardiac complications in children with DM 1.
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