Psychotropic drugs and ventricular repolarisation: The effects on QT interval, T-peak to T-end interval and QT dispersion

2017 ◽  
Vol 31 (4) ◽  
pp. 453-460 ◽  
Author(s):  
Tiziano Acciavatti ◽  
Giovanni Martinotti ◽  
Mariangela Corbo ◽  
Eduardo Cinosi ◽  
Matteo Lupi ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Psychotropic Drugs ◽  
Qt Interval ◽  
Cardiac Death ◽  
Strong Association ◽  
Qt Dispersion ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Ventricular Repolarisation ◽  
Increased Risk

Objective: We aimed to investigate in a clinical setting, the effects of different classes of psychotropic drugs on cardiac electrophysiological measures linked with an increased risk of sudden cardiac death. Methods: We conducted a cross-sectional study in a population of 1059 psychiatric inpatients studying the effects of various psychotropic drugs on the T-peak to T-end (TpTe) interval, QT dispersion and QT interval. Results: Methadone use showed a strong association with TpTe prolongation (odds ratio (OR)=12.66 (95% confidence interval (CI), 3.9–41.1), p<0.001), an effect independent from action on QT interval. Mood stabilisers showed significant effects on ventricular repolarisation: lithium was associated with a TpTe prolongation (OR=2.12 (95% CI, 1.12–4), p=0.02), while valproic acid with a TpTe reduction (OR=0.6 (95% CI, 0.37–0.98), p=0.04). Among antipsychotics, clozapine increased TpTe (OR=9.5 (95% CI, 2.24–40.39), p=0.002) and piperazine phenothiazines increased QT dispersion (OR=2.73 (95% CI, 1.06–7.02), p=0.037). Conclusions: Treatment with psychotropic drugs influences TpTe and QT dispersion. These parameters might be considered to better estimate the sudden cardiac death risk related to specific medications. Beyond antipsychotics and antidepressants, mood stabilisers determine significant effects on ventricular repolarisation.

scholarly journals Seroprevalence of the SARS-CoV-2 antibody in healthcare workers: a multicentre cross-sectional study in 10 Colombian cities

2021 ◽  
pp. oemed-2021-107487
Author(s):  
Jeadran Nevardo Malagón-Rojas ◽  
Marcela Mercado-Reyes ◽  
Yezith G Toloza-Pérez ◽  
Eliana L Parra Barrera ◽  
Marien Palma ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Strong Association ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Risk Of Infection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference ◽  
Automated Immunoassay

BackgroundHealthcare workers are at increased risk of infection due to occupational exposure to SARS-CoV-2-infected patients. The objective of this study was to determine the seroprevalence of SARS-CoV-2 in healthcare workers in Colombia.MethodsThis study is a cross-sectional study focused on estimating the seroprevalence of SARS-CoV-2 antibodies in healthcare workers from 65 hospitals in 10 cities in Colombia during the second semester of 2020. The seroprevalence was determined using an automated immunoassay (Abbott SARS-CoV-2 CLIA IgG). The study included a survey to establish the sociodemographic variables and the risk of infection. A multivariate model was used to evaluate the association between the results of seroprevalence and risk factors.ResultsThe global seroprevalence of antibodies against SARS-CoV-2 was 35% (95% Bayesian CI 33% to 37%). All the personnel reported the use of protective equipment. General services personnel and nurses presented the highest ratios of seroprevalence among the healthcare workers. Low socioeconomic strata have shown a strong association with seropositivity.ConclusionThis study estimates the prevalence of SARS-CoV-2 infection among healthcare workers. Even though all the personnel reported the use of protective equipment, the seroprevalence in the general services personnel and nurses was high. Also, a significant difference by cities was observed.

scholarly journals Pattern and prevalence of metabolic syndrome in obese adolescents aged 10-18 years: a community based study

2020 ◽  
Vol 7 (6) ◽  
pp. 1344
Author(s):  
K. Jothilakshmi ◽  
Vadivel Vinoth ◽  
Suvetha Kannappan
Keyword(s):  
Metabolic Syndrome ◽  
Strong Association ◽  
Cross Sectional Study ◽  
Cardiovascular Morbidity ◽  
Age Group ◽  
Obese Children ◽  
Lifestyle Modifications ◽  
Cross Sectional ◽  
Increased Risk

Background: The prevalence and magnitude of childhood obesity is increasing in pediatric age group. Incidence of metabolic syndrome is high among obese children and adolescents leading to increased risk of cardiovascular morbidity in long term. For this reason, recognition of metabolic syndrome in obese children is of great importance.Methods: This study was a cross-sectional study carried out among children aged 10-18 years from both urban and rural schools in Coimbatore. Children were screened, sample for metabolic studies collected after consent and analyzed.Results: Total 1582 children in the age group of 10-18 years were screened. 300 children were recruited. Among the studied group, 19.3% were overweight, 30.7% were obese. Metabolic syndrome was present in 55.1% of obese and overweight children. Hyperinsulinemia was present in 30% of obese children.Conclusions: This study done in adolescent school children showed a strong association between obesity and early onset of metabolic syndrome. Early intervention with lifestyle modifications is strongly recommended to prevent long term cardiovascular morbidity. 

Abstract 13067: When Are 3 ECG Leads Better Than 12? Streamlining and Optimizing ECG Assessment in Sudden Death Prediction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Isabelle Ruedisueli ◽  
Joyce Ma ◽  
Karishma Lakhani ◽  
Randy Nguyen ◽  
Jeffrey Gornbein ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Qt Interval ◽  
Cardiac Death ◽  
Qrs Complex ◽  
T Wave ◽  
Maximum Value ◽  
Increased Risk ◽  
Secondary Outcomes ◽  
Ecg Leads ◽  
Better Than

Introduction: Prolonged Tpeak to Tend (Tp-e) interval, an index of repolarization on the 12-lead ECG, is associated with increased risk for sudden cardiac death. However, there is no current consensus on which of the 12 leads is the most sensitive to measure the longest Tp-e interval. Aim: The aim of this study was to measure all 12 ECG leads and to analyze whether there are leads that are most sensitive to detect prolongation of Tp-e in order to optimize methodology for future investigations. Methods: Fifteen healthy volunteers (F/M 6/9; mean age 25 yrs) were included in our study. We recorded the 12-lead ECG for 5-minutes. Tp-e was defined as the interval from the peak of the T wave to the end of the T wave. QT is the interval from QRS complex onset to the end of the T wave. Using commercially available software (AdInstruments), three primary outcomes, Tp-e interval, Tp-e/QT, Tp-e/QTc ratios, and two secondary outcomes, QT, QTc intervals, were determined. Results: The location of maximum value for primary outcomes (Tp-e, Tp-e/QT, Tp-e/QTc) were not evenly distributed across the 12 leads, but most frequently was located in leads V2, V3 & V4. The maximum Tp-e was located in one of these three leads 79.7% of the time (CI 69.4, 89.9%) vs other leads (p=0.007, Figure). Conversely, maximum values for the secondary outcomes (QT, QTc) were located in AVL, AVR and III (Figure). Two of the leads, V5 and V6, never had a maximum value for any outcomes. Conclusion: Preliminary findings in our study suggest that investigators should focus on leads V2, V3 & V4 to detect prolongation of Tp-e intervals and leads AVL, AVR & III for prolongation of QT interval when investigating associations with sudden cardiac death.

scholarly journals Secondary risk factors of sudden cardiac death and genes of arterial hypertension

2020 ◽  
Vol 12 (3) ◽  
pp. 27-34
Author(s):  
Vasilii A. Kachnov ◽  
Vadim V. Tyrenko ◽  
Svetlana N. Kolyubaeva ◽  
Lilia A. Myakoshina ◽  
Alexandra S. Buntovskaya
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Sudden Cardiac Death ◽  
Arterial Hypertension ◽  
Qt Interval ◽  
Cardiac Death ◽  
Risk Variant ◽  
Corrected Qt Interval ◽  
Increased Risk ◽  
Heterozygous Variant

Purpose. To study the influence of polymorphisms of arterial hypertension genes and their various combinations on individual risk factors of sudden cardiac death. Materials and methods. 319 young people from 18 to 24 years of age who are entering military service by conscription were examined. The survey identified 69 individuals with signs of increased risk of sudden cardiac death after being examined for secondary risk factors of sudden cardiac death and taken a blood test to determine the polymorphisms of the genes AGT 521 CT, GNB3 825 CT, CYP11B2 344 CT, NOS3 786 TC. Results. The greatest influence on the severity of secondary risk factors was exerted by the following variants of a combination of gene polymorphisms: AGT 521 CT and NOS3 786 TC in the individuals with a heterozygous risk variant, both genes showed a significant increase in the duration of the corrected QT interval, heart rate, and a decrease in heart rate variability. AGT 521 CT and CYP11B2 344 CT homozygous risk variant of the CYP11B2 344 CT and the heterozygous risk variant AGT 521 CT is associated with a longer duration of the corrected QT interval, and the heterozygous risk variant for both genes is associated with higher heart rate values. AGT 521 CT and GNB3 825 CT combination of a homozygous risk variant of the gene GNB3 825 CT and the heterozygous variant of the gene AGT 521 CT is associated with the greatest effect on a heart rate. Conclusions. The presence of a homozygous risk variant of the gene NOS3 786 TC, a heterozygous risk variant of the gene GNB3 825 CT is prognostically unfavorable for its effect on the severity of secondary risk factors for sudden cardiac death. The combination of the heterozygous variant AGT 521 CT with a heterozygous variant of NOS3 786 TC and a homozygous risk variant by the gene CYP11B2 344 CT and the heterozygous risk variant AGT 521 CT are also the most unfavorable in terms of its effect on secondary risk factors for sudden cardiac death. Secondary risk factors of sudden cardiac death are influenced by both individual polymorphisms of genes of arterial hypertension, and their various combinations.

scholarly journals SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study

Thorax ◽  
2020 ◽  
Vol 75 (12) ◽  
pp. 1089-1094 ◽  
Author(s):  
Adrian Shields ◽  
Sian E Faustini ◽  
Marisol Perez-Toledo ◽  
Sian Jossi ◽  
Erin Aldera ◽  
...  
Keyword(s):  
Intensive Care ◽  
Healthcare Workers ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Nasopharyngeal Swab ◽  
Sectional Study ◽  
University Hospitals ◽  
Cross Sectional ◽  
General Internal ◽  
Increased Risk

ObjectiveTo determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.DesignA cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.SettingUniversity Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.Participants545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.InterventionParticipants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.Main outcome measureProportion of participants demonstrating infection and positive SARS-CoV-2 serology.ResultsThe point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).Conclusions and relevanceWe identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.

scholarly journals Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049967
Author(s):  
Karen Sól Saevarsdóttir ◽  
Hildur Ýr Hilmarsdóttir ◽  
Ingibjörg Magnúsdóttir ◽  
Arna Hauksdóttir ◽  
Edda Bjork Thordardottir ◽  
...  
Keyword(s):  
Severe Disease ◽  
Symptom Burden ◽  
Cross Sectional Study ◽  
Illness Severity ◽  
University Education ◽  
Adjusted Relative Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Increased Risk

ObjectiveTo test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity.DesignPopulation-based cross-sectional study.SettingIceland.ParticipantsA total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19.Main outcome measuresSymptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities.ResultsCompared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44).ConclusionsSevere disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19.

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