• Title/Summary/Keyword: QTc

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Clinical Correlates of QTc Prolongation in Patients with Schizophrenia : A Retrospective Study (조현병 환자에서 QTc 간격연장에 관련되는 요인 : 후향적 연구)

  • Lee, Jung Suk;Park, Jaesub;Park, Sunyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.11-16
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    • 2021
  • Objectives : QTc prolongation due to antipsychotics is of major concern because it may lead to fatal ventricular arrhythmia such as torsade de pointes. However, few studies have been conducted on QTc prolongation due to antipsychotics, especially in South Korea. This study aimed to investigate how demographic and clinical variables affect QTc interval in patients with schizophrenia. Methods : By retrospectively reviewing medical records, we assessed QTc interval, demographic data and clinical features of 441 (175 males) patients with schizophrenia who admitted to the psychiatric ward of a general hospital. To explore the predictive factors for QTc interval, hierarchical regression analysis was performed with QTc interval as the dependent variable. Results : The mean QTc interval was 417.2±28.4 ms. In the hierarchical regression analysis, the use of short-acting antipsychotic injection was the strongest predictor of the QTc prolongation. Conclusions : This study demonstrated that the use of short-acting antipsychotic injection may affect QTc prolongation in patients with schizophrenia. This result suggests that more attention should be paid to the use of short-acting antipsychotic injection in the treatment of schizophrenia.

The corrected QT (QTc) prolongation in hyperthyroidism and the association of thyroid hormone with the QTc interval

  • Lee, Ye Seung;Choi, Joong Wan;Bae, Eun Ju;Park, Won Il;Lee, Hong Jin;Oh, Phil Soo
    • Clinical and Experimental Pediatrics
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    • v.58 no.7
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    • pp.263-266
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    • 2015
  • Purpose: Ventricular repolarization is assessed using the QT interval corrected by the heart rate (QTc) via an electrocardiogram (ECG). Prolonged QTc is associated with an increased risk of arrhythmias and cardiac mortality. As there have been few reports regarding the effects of hyperthyroidism on ventricular repolarization, we studied the association between serum free thyroxine (free T4 [fT4]) and thyroid stimulating hormone (TSH) levels and the QTc interval. Methods: Thirty-eight patients with hyperthyroidism (<30 years old) were included, and we used their clinical records and available ECGs (between August 2003 and August 2011) to evaluate the association between their fT4 and TSH levels and their QTc interval. In addition, we studied the ECGs of 72 age-matched patients with no hyperthyroidism (control group) and compared their data with that from the patients group. Results: The QTc duration in patients with hyperthyroidism was significantly prolonged compared to that in the control subjects (P<0.001). In addition, the number of hyperthyroid patients with abnormal prolonged QTc was significantly higher than that in the control group (P<0.001). Among the patients with hyperthyroidism, patients with prolonged QTc and borderline QTc had higher fT4 levels and there was positive correlation between their fT4 levels and their QTc interval (P<0.05). However, no correlation was observed between their TSH levels and their QTc interval. Conclusion: We report that hyperthyroidism is associated with QTc prolongation. The correlation between the fT4 levels and the QTc interval suggests that thyroid status is associated with QTc values and the risk of cardiac mortality.

Association of Antipsychotic-Induced QTc Prolongation with 5-HTTLPR (항정신병약물로 인한 QTc 지연과 5-HTTLPR의 연관성)

  • Seo, Beom-Joo;Rhee, Jung-Goo;Park, Sung-Woo;Kong, Bo-Geum;Chung, Do-Oun;Kim, Young-Hoon
    • Korean Journal of Biological Psychiatry
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    • v.11 no.1
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    • pp.49-53
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    • 2004
  • Objective:A Comparison of QTc prolongation for various antipsychotics and an analysis of QTc prolongation for the various types of serotonin transporter polymorphism were performed. Method:EKG was checked, followed by QTc measurement as Bazett's correction, and the serotonin transporter polymorphism was examined in 110 chronic schizophrenia patients were performed EKG before 24 weeks ago. We defiened QTc prolongation as over 450ms. The risk factor of sudden cardiac death were defiend as QTc prolongation and or 60ms in delta value. Result:The prevalence of QTc prolongation in this study was 7.3%, and the prevalence of over 60ms was 4.5%. Patients who had the risk factors were 10(9.1%). 6/52 who prescribed atypical antipsychotics and 2/58 who prescribed haloperidol showed QTc prolongation. The prevalence who had the risk factor of sudden cardiac death were 16% in atypical antipsychotics group, 3.4% in haloperidol group. QTc prolongation were observed more frequently in l/l type than s/s type. l allele frequency were 50% in QTc prolongated group, 19% in not prolongated group. l allele had an association with QTc prolongation(p<0.01). Conclusion:The prevalence of QTc prolongatin was frequent in chronic schizophrenia patients who were prescribed atypical antipsychotics. It has strong association with l allele of 5-HTTLPR.

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A Study of QTc Interval in EKG and Body Fat Distribution in Middle Aged Woman (운동부하검사시 중년여성의 심전도 QTc 간격과 체내 지방분포에 관한 연구)

  • Kim, Eun-Young;Kim, Keon-Yeop;Lee, Moo-Sik;Na, Bak-Ju;Bae, Seok-Hwan;Lim, Nam-Gu
    • Proceedings of the KAIS Fall Conference
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    • 2009.05a
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    • pp.222-226
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    • 2009
  • 본 연구는 40~50대 중년여성을 대상으로 측정한 체내지방분포와 심전도 QTc 간격과의 관련성을 규명하기 위하여 2004년 7월부터 2005년 8월까지 일개 광역도 소재의 일개 군 보건소 운동처방실을 방문한 여자 100명을 대상으로 체내지방분포와 심전도 QTc 간격 등을 측정하였다. 주요 결과는 다음과 같다. 1. 중년여성의 안정시 심전도 QTc 간격과 체내지방분포와의 상관관계에서는 비만도, 체질량지수, 체지방율, 허리둘레, 엉덩이둘레, 허리-엉덩이둘레 비가 유의한 상관관계를 보였다. 2. 체지방율이 30% 이상인 비만군과 30% 미만인 정상군의 QTc 간격은 비만군이 정상군에 비해 QTc 간격이 더 연장된 결과를 보였다. 3. 허리둘레가 80cm 이상인 복부비만군과 80cm 미만인 정상군의 QTc 간격은 복부비만군이 정상군에 비해 QTc 간격이 더 연장된 결과를 보였다. 4. 연구대상자의 안정시 QTc 간격을 종속변수로 한 다중회귀분석을 실시한 결과를 살펴보면, 체지방율과 허리둘레가 유의하게 나타났다. 40~50대 중년여성의 심전도 QTc 간격에 영향을 주는 요인에는 체내지방분포에 따른 비만도, 체질량지수, 체지방율, 허리둘레, 엉덩이둘레 등 여러 요인들이 복합적으로 관련되는 것으로 판단되어지며, 그 중 전체지방분포를 나타내는 체지방율이 가장 크게 관련되는 것으로 판단되어진다.

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QTc Prolongation due to Psychotropic Drugs Intoxication and Its Risk Assessment (향정신성 약물 중독에 의한 QTc 연장과 그 위험성에 대한 고찰)

  • Park, Kwan Ho;Hong, Hoon Pyo;Lee, Jong Seok;Jeong, Ki Young;Ko, Seok Hun;Kim, Sung Kyu;Choi, Han Sung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.66-77
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    • 2020
  • Purpose: The aims of the present study were twofold. First, the research investigated the effect of an individual's risk factors and the prevalence of psychotropic drugs on QTc prolongation, TdP (torsades de pointes), and death. Second, the study compared the risk scoring systems (the Mayo Pro-QT risk score and the Tisadale risk score) on QTc prolongation. Methods: The medical records of intoxicated patients who visited the emergency department between March 2010 and February 2019 were reviewed retrospectively. Among 733 patients, the present study included 426 psychotropic drug-intoxicated patients. The patients were categorized according to the QTc value. The known risk factors of QTc prolongation were examined, and the Mayo Pro-QT risk score and the Tisadale risk score were calculated. The analysis was performed using multiple logistic regression, Spearman correlation, and ROC (receiver operating characteristic). Results: The numbers in the mild to moderate group (male: 470≤QTc<500 ms, female: 480≤QTc<500 ms) and severe group (QTc≥500 ms or increase of QTc at least 60ms from baseline, both sex) were 68 and 95, respectively. TdP did not occur, and the only cause of death was aspiration pneumonia. The statically significant risk factors were multidrug intoxications of TCA (tricyclic antidepressant), atypical antipsychotics, an atypical antidepressant, panic disorder, and hypokalemia. The Tisadale risk score was larger than the Mayo Pro-QT risk score. Conclusion: Multiple psychotropic drugs intoxication (TCA, an atypical antidepressant, and atypical antipsychotics), panic disorder, and hypokalemia have been proven to be the main risk factors of QTc prolongation, which require enhanced attention. The present study showed that the Tisadale score had a stronger correlation and predictive accuracy for QTc prolongation than the Mayo Pro-QT score. As a result, the Tisadale risk score is a crucial assessment tool for psychotropic drug-intoxicated patients in a clinical setting.

Remote Seabed Classification Based on the Characteristics of the Acoustic Response of Echo Sounder: Preliminary Result of the Suyoung Bay, Busan (측심기의 음향반사 특성을 이용한 해저퇴적물의 원격분류: 부산 수영만의 예비결과)

  • Kim Gil Young;Kim Dae Choul;Kim Yang Eun;Lee Kwang Hoon;Park Soo Chul;Park Jong Won;Seo Young Kyo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.35 no.3
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    • pp.273-281
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    • 2002
  • Determination of sediment type is generally based on ground truthing. This method, however, provides information only for the limited sites. Recent developments of remote classification of seafloor sediments made it possible to obtain continuous profiles of sediment types. QTC View system, which is an acoustic instrument providing digital real-time seabed classification, was used to classify seafloor sediment types in the Suyoung Bay, Pusan. QTC View was connected to 50 kHz echo sounder, All parameters of QTC View and echo sounder are uniformly kept during survey. By ground truthing, the sediments are classified into seven types, such as slightly gravelly sand, slightly gravelly sandy mud, gravelly muddy sand, clayey sand, sandy mud, slightly gravelly muddy sand, and rocky bottom. By the first remote classification using QTC View, four sediment types are clearly identified, such as slightly gravelly sand, gravelly mud, slightly gravelly muddy sand, and rocky bottom. These are similar to the result of the second survey. Also the result of remote classification matches well with that of ground truthing, but for sediment type determined by minor component. Therefore, QTC View can effectively be used for remote classification of seafloor sediments.

Effects of 12 Week Regular Aerobic Exercise on ST-segment and QTc Interval in Type 2 Diabetes Mellitus Patients (12주 규칙적인 유산소 운동이 제 2형 당뇨환자의 ST 분절과 QTc 연장에 미치는 영향)

  • Kim, Young-Il;Paik, Il-Young;Jin, Hwa-Eun;Suh, Ah-Ram;Kwak, Yi-Sub;Woo, Jin-Hee
    • Journal of Life Science
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    • v.19 no.1
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    • pp.81-86
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    • 2009
  • The purpose of the present study was to examine effect of 12 week regular aerobic exercise on ST-segment and QTc interval in middle age type 2 diabetes mellitus (T2DM) patients. The subjects consist of 13 type 2 diabetes mellitus (T2DM) patients in middle age men and all of them had no other complications. Subjects participated in aerobic exercise training for 12 weeks. They started to exercise for $20{\sim}60$ min at $60{\sim}80%$ of $HR_{max}$, (exercise intensity has been increased gradually) per day, $3{\sim}5$ times a week. The results were compared before and after. Weight and BMI, % body fat, fasting glucose, HOMA-IR, $_{peak}DBP$ were significantly decreased and $_{peak}HR$, $_{peak}VO_2$, exercisre time were significantly increased after 12 week aerobic exercise. Also, QTc interval and ST-segment were significantly decreased during at rest, peak exercise after 12 week aerobic exercise. Conclusionally, 12 week aerobic exercise may be improvement in decreased cardiovascular mortality factors (ST-segment) and abnormal autonomic dysfunction (QTc interval) and potentially increased exercise capacity.

Relationship between Corrected QT Interval and Cardiovascular Risk Factors in Young Healthy Adults: The Kangwha Study (젊은 성인에서 교정 QT간격과 심혈관질환 위험요인의 관련성: 강화연구)

  • Ahn, Song-Vogue;Kim, Hyeon-Chang;Hur, Nam-Wook;Ha, Kyoung-Soo;Jang, Hoo-Sun;Kim, Jin-Bae;Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.6
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    • pp.455-461
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    • 2006
  • Objectives : Prolongation of the heart rate-corrected QT (QTc) interval has been reported to be associated with cardiovascular morbidity and mortality. However, few studies have examined the relationship between the QTc interval and cardiovascular risk factors in young healthy people, The aim of this study was to examine the associations between the QTc interval and cardiovascular risk factors in young healthy adults. Methods : This study was performed as part of the Kangwha study, which started in 1986, and is an on-going follow-up study on blood pressure and related cardiovascular risk factors. In follow-up examinations during 2005, cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry and carotid ultrasonography, were measured, and questionnaires on health behaviors completed by 127 men and 149 women aged 25 years. The QTc interval was measured on the resting 12-lead electrocardiogram using an automatic analysis program. Results : The mean QTc interval was significantly longer in women $(419{\pm}17ms)$ than in men $(405{\pm}17ms)$ (p<0.001). A significant positive correlation was found between the QTc interval and waist-hip ratio (p=0.030) in men. Women showed a positive correlation between the QTc interval and systolic blood pressure (p=0.017). On a multiple regression analysis, the QTc interval was positively associated with the waist-hip ratio in men (p=0.012) and with the systolic blood pressure (p=0.020) in women. Conclusions : In young healthy Korean adults, the QTc interval was independently associated with the waist-hip ratio in men and with the systolic blood pressure in women.

Predicting Factors Associated with Large Amounts of Glyphosate Intoxication in the Early-Stage Emergency Department: QTc Interval Prolongation (응급실 초기에 다량의 글라이포세이트 중독과 관련된 예측인자: QTc 간격 연장)

  • Kyung, Dong-Soo;Jeon, Jae-Cheon;Choi, Woo Ik;Lee, Sang-Hun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.130-135
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    • 2020
  • Purpose: Taking large amounts of glyphosate is life-threatening, but the amounts of glyphosate taken by patients for suicide are not known precisely. The purpose of this study was to find the predictors of large amounts of glyphosate ingestion. Methods: This retrospective study analyzed patients presenting to an emergency department with glyphosate intoxication between 2010 and 2019, in a single tertiary hospital. The variables associated with the intake amounts were investigated. The parameters were analyzed by multivariate variate logistic regression analyses and the receiver operating characteristic (ROC) curve. Results: Of the 28 patients with glyphosate intoxication, 15 (53.6%) were in the large amounts group. Univariate analysis showed that metabolic acidosis, lactic acid, and corrected QT (QTc) interval were significant factors. In contrast, multivariate analysis presented the QTc interval as the only independent factor with intoxication from large amounts of glyphosate. (odds ratio, 95% confidence interval: 1.073, 1.011-1.139; p=0.020) The area under the ROC curve of the QTc interval was 0.838. Conclusion: The QTc interval is associated significantly with patients who visit the emergency department after being intoxicated by large amounts of glyphosate. These conclusions will help in the initial triage of patients with glyphosate intoxication.

Toxic Effect of Azalea Extract on Cardiovascular System (진달래 꽃잎의 추출물이 심혈관계에 미치는 영향)

  • Chun, Jun-Ha;Chung, Sung-Bok;Kang, Seung-Ho;Kim, Yeong-Jo;Shim, Bong-Sub;Lee, Hyun-Woo;Shin, Dong-Gu;Park, Jong-Min
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.52-62
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    • 1991
  • The toxic effect of azalea extract, expecially on cardiovascular system, is relatively unclear. The purpose of this study is to study the possible underlying mechanism and effect of toxic ingredient of azalea on cardiovascular system. The 71 healthy rabbits were divided into 10 groups : In group as preliminary study ; 4cc of normal saline was administered intravenously(N) ; 0.7gm/kg and 1.0gm/kg of azalea extract was administered respectively in the same route, volume(A1, A2) ; atropine was administered intravenously(A) ; after pretreatment with atropine(0.04mg/kg) to block parasympathetic system, azalea extract was injected like the above groups(AA1, AA2) ; normal saline, 0.7gm/kg and 1.0gm/kg of azalea extract were administered respectively with 0.2cc(1 : 1000) epinephrine(E0,E1,E2). We measured the following indices at I minute interval during first 10 minutes and then 10 minute interval during next 30 minutes : RR interval, QTc interval, maximal systolic and diastolic pressure drop with occuring time and presence of significant arrhythmia. The results were as follows : 1. The changes of RR interval, QTc interval were significantly increased in groups by Azalea extract. The blood pressure change was significantly decreased in groups by Azalea extract. There were no significant differences according to dosage of Azalea extract. 2. The changes of RR interval, blood pressure were significant differences between administration of atropine and Azalea extract after pretreatment with atropine, but not in the change of QTc interval. 3. There were no significant differences in the change of RR interval, ATc interval, blood pressure drop according to pretreatment with atropine. 4. The interaction between epineprine and Azalea extract was not noted by the effect of epineprine itself. 5. The ST change by 0.7gm/kg, 1.0gm/kg of Azalea extract was revealed in 1 case(14.0%), 7 case(100%), respectively. 6. Most of all cases with arrhthymia, ventricular tachycardia, ventricular fibrillation, were noted in the group by epineprine, except one case by Azalea extract(1.0gm/kg). It was idioventricular rhythm. In conclusion, azalea extract has negative inotropic and chronotropic effect with arrhythmogenic potential possibly through direct myocardial ischemia or injury but we cann't be absolutely exclusive of actions of autonmic nervous system, especially parasympathetic nervous system.

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