Effect of Alpha-lipoic Acid on the Corrected QT Interval, QT Dispersion and Spatial QRS-T Angle in Patients with Type 2 Diabetes Mellitus and Cardiac Autonomic Neuropathy

Victoria A Serhiyenko (Professor of Danylo Halytsky Lviv National Medical University)
Krystina Kozlovska (Department of endocrinology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine)
Alexandr Serhiyenko (Department of endocrinology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine)

Abstract

Objective: The significance of cardiac autonomic neuropathy has not been fully appreciated and there is no unified treatment algorithm. Aim: To investigate the effects of alpha-lipoic acid on the corrected QT interval (QTc), QT dispersion (QTd) and spatial QRS-T angle in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy. Research designs and methods: 33 patients with type 2 diabetes mellitus and definite stage of cardiac autonomic neuropathy were allocated to two treatment groups: control (n=15) received standard antihyperglycaemic therapy; group 2 (n=18) - in addition alpha-lipoic acid 600 mg/d for three months. The QTc interval, QTd and spatial QRS-T angle parameters were analyzed. Results: It was found out that alpha-lipoic acid contributed to decrease of the QTc, QTd and QRS-T angle. Conclusions: The positive influences of alpha-lipoic acid suggests the feasibility of its administration to patients with type 2 diabetes mellitus and definite stage of cardiac autonomic neuropathy. Obtained results suggest that the efficacy of alpha-lipoic acid is the result of its direct effect on the investigated indexes.

Keywords

Type 2 diabetes mellitus, Cardiac autonomic neuropathy, Alpha-lipoic acid, Corrected QT interval, Spatial QRS-T angle

Full Text:

PDF

References

Park S, Karunakaran U, Ho Jeoumg N, Jeon J-H & Lee I-K. Physiological effect and therapeutic application of alpha lipoic acid. Current Medicinal Chemistry, 2014, 21, 32: 3636-3645. DOI: 10.2174/0929867321666140706141806

Rochette L, Ghibu S, Muresan A & Vergely C. Alpha-lipoic acid: molecular mechanisms and therapeutic potential in diabetes. Canadian Journal of Physiology and Pharmacology, 2015, 93, 1021-1027. DOI: 10.1139/cjpp-2014-0353

Peter K & Wil W. Antioxidant therapy by lipoic acid in various illnesses: Reactive oxygen species and oxidative stress. Novel Approaches in Drug Designing & Development, 2018, 3, 3: 555612. DOI: 10.19080/NAPDD.2017.03.555612

Cha SA, Yun J-S, Lim T-S, Min K, Song K-H, Yoo K-D, Park Y-M, Ahn Y-B & Ko S-H. Diabetic cardiovascular autonomic neuropathy predicts recurrent cardiovascular diseases in patients with type 2 diabetes. PLoS ONE, 2016, 11, 10: e0164807. DOI: 10.1371/journal.pone.0164807

Lee J & Cho JH. Effects of high-dose α-lipoic acid on heart rate variability of type 2 diabetes mellitus patients with cardiac autonomic neuropathy in Korea. Diabetes & Metabolism Journal, 2017, 41, 4: 275-283. DOI: 10.4093/dmj.2017.41.4.275

Serhiyenko V, Serhiyenko L & Serhiyenko A. Alpha-lipoic acid and diabetic cardiac autonomic neuropathy. MedCrave Online Journal of Public Health, 2019, 8, 1: 8-10. DOI: 10.15406/mojph.2019.08.00276

Veglio M, Chinaglia A & Cavallo-Perin P. QT interval, cardiovascular risk factors and risk of death in diabetes. Journal of Endocrinological Investigation, 2004, 27, 2: 175-181. DOI: 10.1007/BF03346265

Prince CT, Secrest AM, Mackey RH, Arena VC, Kingsley LA & Orchard TJ. Cardiovascular autonomic neuropathy, HDL cholesterol, and smoking correlate with arterial stiffness markers determined 18 years later in type 1 diabetes. Diabetes Care, 2010, 33, 3: 652-657. DOI: 10.2337/dc09-1936

Desouza CV, Bolli GB & Fonseca V. Hypoglycemia, diabetes, and cardiovascular events. Diabetes Care, 2010, 33, 6: 1389-1394. DOI: 10.2337/dc09-2082

Voulgari C, Tentolouris N, Papadogiannis D, Moyssakis I, Perrea D, Kyriaki D & Katsilambros N. Increased left ventricular arrhythmogenicity in metabolic syndrome and relationship with myocardial performance, risk factors for atherosclerosis, and low-grade inflammation. Metabolism, 2010, 59, 159-165. DOI: 10.1016/j.metabol.2009.06.028

Voulgari C, Pagoni S, Tesfaye S & Tentolouris N. The spatial QRS-T angle: implications in clinical practice. Current Cardiology Reviews, 2013, 9, 3: 197-210. DOI: 10.2174/1573403x113099990031

Raposeiras-Roubin S, Virgos-Lamela A, Bouzas-Cruz N, Lopez-Lopez A, Castineira-Busto M, Fernandez-Garda, Garsia-Castello A, Rodrigues-Manero M, Garsia-Acuna JM, Abu-Assi E et al. Usefulness of the QRS-T angle to improve long-term risk stratification of patients with acute myocardial infarction and depressed left ventricular ejection fraction. The American Journal of Cardiology, 2014, 113, 8: 1312-1319. DOI: 10.1016/j.amjcard.2014.01.406

Walsh JA 3rd, Soliman EZ, Ilkhanoff L, Ning H, Liu K, Nazarian S & Lloyd-Jones DM. Prognostic value of frontal QRS-T angle in patients without clinical evidence of cardiovascular disease (from the Multi-Ethnic Study of Atherosclerosis). The American Journal of Cardiology, 2013, 112, 12: 1880-1884. DOI: 10.1016/j.amjcard.2013.08.017

Ziegler D, Low PA, Litchy WJ, Boulton AJ, Vinik AI, Freeman R, Samigullin R, Tritschler H, Munzel U, Maus J et al. Efficacy and safety of antioxidant treatment with α-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial. Diabetes Care, 2011, 34, 9: 2054-2060. DOI: 10.2337/dc11-0503

Vallianou N, Evangelopoulos A & Koutalas P. Alpha-lipoic acid and diabetic neuropathy. The Review of Diabetic Studies, 2009. 6, 4: 230-236. DOI: 10.1900/RDS.2009.6.230

Golbidi S, Badran M & Laher I. Diabetes and alpha lipoic acid. Frontiers in Pharmacology, 2011, 2: 69. DOI: 10.3389/fphar.2011.00069

Shakher J & Stevens MJ. Update on the management of diabetic polyneuropathies. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2011, 4: 289-305. DOI 10.2147/DMSO.S11324

Hosseini A & Abdollahi M. Diabetic neuropathy and oxidative stress: therapeutic perspectives. Oxidative Medicine and Cellular Longevity, 2013, 2013: 168039. DOI: 10.1155/2013/168039

Boghdadi MA, Afify HE, Sabri N, Makboul K & Elmazar M. Comparative study of vitamin B complex combined with alpha lipoic acid versus vitamin B complex in treatment of diabetic polyneuropathy in type 2 diabetic patients. Clinical and Experimental Pharmacology and Physiology, 2017, 7: 241. DOI: 10.4172/2161-1459.1000241

Spallone V, Ziegler D, Freeman R, Bernardi L, Frontoni S, Pop-Busui R, Stevens M, Kempler P, Hilsted J, Tesfaye S et al. Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes/Metabolism Research and Reviews, 2011, 27, 7: 639-653. DOI: 10.1002/dmrr.1239

Bazett HC. An analysis of the time-relations of electrocardiograms. Annals of Noninvasive Electrocardiology, 1997, 2, 2: 177-194. DOI: 10.1111/j.1542-474X.1997.tb00325.x

Borleffs CJ, Scherptong RW, Man SC, van Welsenes GH, Bax JJ, van Erven L, Swenne CA & Schalij MJ. Predicting ventricular arrhythmias in patients with ischemic heart disease: clinical application of the ECG-derived QRS-T angle. Circulation: Arrhythmia and Electrophysiology, 2009, 2, 5: 548-554. DOI: 10.1161/CIRCEP.109.859108

Adamec J & Adamec R. ECG Holter: Guide to Electrocardiographic Interpretation. New York, Springer-Verlag US, 2008. ISBN 978-0-387-78187-7

Valensi P, Johnson NB, Maison-Blanche P, Extramania F, Motte G & Coumel P. Influence of cardiac autonomic neuropathy on heart rate dependence of ventricular repolarization in diabetic patients. Diabetes Care, 2002, 25, 5: 918-923. DOI: 10.2337/diacare.25.5.918

Serhiyenko V & Serhiyenko A. Diabetic cardiovascular neuropathy. Stavropol, Logos Publishers, 2018. DOI: 10.18411/dia012018.49

Pillai JN & Madhavan S. Cardiac autonomic neuropathy and QTc interval in type 2 diabetes. Heart India, 2015, 3, 1: 8-11. DOI: 10.4103/2321-449X.153279

Shay KP, Moreau RF, Smith EJ, Smith AR & Hagen TM. Alpha-lipoic acid as a dietary supplement: molecular mechanisms and therapeutic potential. Biochimica et Biophysica Acta, 2009, 1790, 10: 1149-1160. DOI: 10.1016/j.bbagen.2009.07.026

Ibrahimpasic K. Alpha lipoic acid and glycaemic control in diabetic neuropathies at type 2 diabetes treatment. Medical Archives, 2013, 67, 1: 7-9. DOI: 10.5455/medarh.2013.67.7-9

Feng B, Yan XF, Xue JL, Xu L & Wang H. The protective effects of α-lipoic acid on kidneys in type 2 diabetic Goto-Kakisaki rats via reducing oxidative stress. International Journal of Molecular Sciences, 2013, 14, 4: 6746-6756. DOI: 10.3390/ijms14046746

DOI: https://doi.org/10.30564/jer.v2i2.2750

Refbacks

There are currently no refbacks.

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.



Remember me