Journals / Koşuyolu Heart Journal / 2018 / Cilt: 21 - Sayı: 3

Effects of Lithium Therapy on Ventricular Repolarization in Bipolar Disorder Patients

Bipolar Bozukluk Hastalarında Lityum Tedavisinin Ventriküler Repolarizasyon Üzerine Etkileri

Pages
193–197
Publication Date
2018-12-02
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Prolonged Tp-e interval may be a useful indicator of increased risk of ventricular arrhythmia in patients using lithium therapy.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Introduction: Bipolar disorder (BD) is a significant mental health concern in the world.
📊
Key Findings & Data:Patients and Methods: Forty-six BD patients under lithium therapy and 45 participants in a control group were included in our study.
💡
Conclusion & Impact:Conclusion: Prolonged Tp-e interval may be a useful indicator of increased risk of ventricular arrhythmia in patients using lithium therapy.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Bipolar bozukluk · lityum · Tp-e interval

Abstract

Introduction: Bipolar disorder (BD) is a significant mental health concern in the world. Most of the drugs used in the treatment of bipolar disease may cause life-threatening arrhythmias by affecting the distribution of ventricular repolarization (VR). VR is commonly assessed using QT interval and Twave measurements. The aim of this study was to evaluate VR using the T peak to T end (Tp-e) interval and the Tp-e/QT ratio and to investigate the relationship between lithium therapy and VR parameters in patients with BD. Patients and Methods: Forty-six BD patients under lithium therapy and 45 participants in a control group were included in our study. The Tp-e interval and Tp-e/QT ratio were measured using 12derivation electrocardiography (ECG). These parameters were compared between groups. Results: The QT interval (p= 0.01), QTc interval (p= 0.003), Tp-e interval (p< 0.001), and Tpe/QT ratio (p= 0.009) were significantly higher in patients with BD than in the control group. There was a positive correlation between the Tp-e interval and serum lithium levels (r= 0.317, p< 0.032). In addition, the increased serum lithium level (β= 0.398, p= 0.007) was found to be an independent predictor of the prolonged Tp-e interval. Conclusion: Prolonged Tp-e interval may be a useful indicator of increased risk of ventricular arrhythmia in patients using lithium therapy.

Özet

Giriş: Bipolar bozukluk (BD) dünyada önemli bir mental sağlık sorununudur. Bipolar bozukluk tedavisinde kullanılan ilaçların çoğu, ventriküler repolarizasyonun (VR) dağılımını etkileyerek hayatı tehdit eden aritmilere neden olabilir. VR genellikle QT aralığı ve T dalgası ölçümleri kullanılarak değerlendirilir. Bu çalışmanın amacı, Tp-e intervali ve Tp-e/QT oranını kullanarak VR’yi değerlendirmek ve bipolar bozukluğu olan hastalarda lityum tedavisi ve VR parametreleri arasındaki ilişkiyi araştırmaktır. Hastalar ve Yöntem: Çalışmamıza lityum tedavisi alan 46 hasta ve 45 katılımcıdan oluşan kontrol grubu dahil edildi. Tp-e aralığı ve Tp-e/QT oranı 12-derivasyon elektrokardiyografi (EKG) kullanılarak ölçüldü. Bu parametreler gruplar arasında karşılaştırıldı. Bulgular: Bipolar bozukluk olan hastalarda QT interval (p= 0.01), QTc interval (p = 0.003), Tp-e interval (p< 0.001) ve Tp-e / QT oranı (p= 0.009) kontrol grubuna göre anlamlı olarak yüksek bulundu. Tp-e intervali ile serum lityum düzeyleri arasında pozitif korelasyon vardı (r= 0.317, p< 0.032). Ayrıca artmış serum lityum seviyesi (β= 0.398, p= 0.007), uzun Tp-e aralığının bağımsız bir belirleyicisi olarak bulundu. Sonuç: Uzamış Tp-e intervali, lityum tedavisi kullanan hastalarda artmış ventriküler aritmi riskinin yararlı bir göstergesi olabilir.

🔖

Cite This Article

ZENCİR, C., KARAKUŞ, K., KOCABAŞ, O., BAHTİYAR, G., SELVİ, M., KARAMAN, K. (2018). Effects of Lithium Therapy on Ventricular Repolarization in Bipolar Disorder Patients. Koşuyolu Heart Journal, Cilt: 21 - Sayı: 3, 193–197. https://ajindex.com/articles/63872

📄 Full Text PDF Viewer

↗New Tab

References (17)

  1. Demers RG, Heninger GR. Electrocardiographic T-wave changes during lithium carbonate treatment. JAMA 1971;218:381-6
  2. Tilkian AG, Schroeder JS, Kao JJ, Hultgren HN. The cardiovascular effects of lithium in man. Am J Med 1976;61:665-70
  3. Mitchell JE, Mackenzie TB. Cardiac effects of lithium in man: A review. J Clin Psychiatry 1982;43:47-51
  4. Montalescot G, Levy Y, Hatt PY. Serious sinus dysfunction caused by therapeutic doses of lithium. Int J Cardiol 1984;5:94-6
  5. Higham PD, Campbell RW. QT dispersion. Br Heart J 1994;71:508-10
  6. Kors JA, Ritsema van Eck HJ, Van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008;41:575-80
  7. Halboos A, Jockenhövel F. Complete atrioventricular block during lithium therapy within therapeutic range. Dtsch Med Wochenschr 2012;137:2583-5
  8. Paclt I, Slavícek J, Dohnalová A, Kitzlerová E, Pisvejcová K. Electrocardiographic dose-dependent changes in prophylactic doses of dosulepine, lithium and citalopram. Physiol Res 2003;52:311-7
  9. Gupta P, Patel C, Patel H, Narayanaswamy S, Malhotra B, Green JT, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008;41:567-74
  10. Day CP, McComb JM, Campbell RW. QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. Br Heart J 1990;63:342-4
  11. Heviaet J C, Antzelevitch C, Bárzaga FT, Dorantes Sánchez M, Dorticós Balea F, Zayas Molina R, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am CollCardiol 2006;47:1828-34
  12. Haddad PM, Anderson IM. Antipsychotic-related QTc prolongation, torsade de pointes and sudden death. Drugs 2002;62:1649-71
  13. Wright D, Salehian O. Brugada-type electrocardiographic changes induced by long-term lithium use. Circulation 2010;122:418-9
  14. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59(Suppl 20):22-33
  15. Bazett HC. The time relations of the blood-pressure changes after excision of the adrenal glands, with some observations on blood volume changes. J Physiol 1920;53:320-39
  16. Cade JF. Lithium salts in the treatment of psychotic excitement. 1949. Bull World Health Organ 2000;78:518-20
  17. Dunner DL. Optimizing lithium treatment.
Effects of Lithium Therapy on Ventricular Repolarization in Bipolar Disorder Patients — AJIndex