Diabetes and the Risk of Sudden Cardiac Death
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INVASIVE ELECTROPHYSIOLOGY AND PACING (E. KEVIN HEIST, SECTION EDITOR)
Diabetes and the Risk of Sudden Cardiac Death Jesper Svane 1,2
&
Ulrik Pedersen-Bjergaard 3 & Jacob Tfelt-Hansen 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Persons with diabetes mellitus (DM) have increased morbidity and mortality rates compared with persons without DM. Sudden cardiac death (SCD) is a leading cause of death, and multiple studies have found an increased risk of SCD among individuals with DM. This review sought to collect the latest knowledge of the epidemiological and pathophysiological interplay between DM and SCD. Recent Findings Persons with DM have a two- to tenfold increased risk of SCD compared with persons without DM. The underlying mechanisms for the increased risk of SCD are complex and multifactorial. The main pathophysiological contributors are DM-induced cardiac autonomic neuropathy (CAN), metabolic changes, silent ischemia, and polypharmacy. Summary Persons with DM have an increased risk of SCD. Future studies should focus on CAN and the combined risk of QT prolongation from the interplay between CAN, hypoglycemia, and polypharmacy. Genes and pathways involved in control of the autonomic nervous system and cardiac ion channels could be a future focal point. Keywords Sudden cardiac death . Diabetes . Review . Cardiac autonomic neuropathy . Hypoglycemia . Silent ischemia
Introduction Diabetes mellitus (DM) is one of the most common chronic diseases, and its prevalence is increasing worldwide. DM affects multiple organ systems, including the cardiovascular system, and is a well-established risk factor for cardiovascular disease and sudden cardiac death (SCD). Applying the generally accepted criteria and current knowledge, SCD is defined This article is part of the Topical Collection on Invasive Electrophysiology and Pacing * Jesper Svane [email protected] Ulrik Pedersen-Bjergaard [email protected] Jacob Tfelt-Hansen [email protected] 1
The Department of Cardiology, the Heart Centre, Copenhagen University Hospital, Rigshospitalet, Section 2142, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
2
Section of Forensic Pathology, Department of Forensic Medicine, Copenhagen University, Copenhagen, Denmark
3
Department of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerod, Denmark
as a natural and unexpected death of cardiac cause; in unwitnessed cases, such as a person last seen alive and normally functioning
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