Effects of Antipsychotics on Arrhythmogenic Parameters in Schizophrenia Patients: Beyond Corrected QT Interval

Hiroaki Okayasu,1 Takahiro Shinozaki,1 Yumiko Takano,1 Norio Sugawara,1 Kumiko Fujii,2 Norio Yasui-Furukori,1 Yuji Ozeki,2 Kazutaka Shimoda1 1Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan; 2Department of Psychiatry, Shiga University of Medical Science, Shiga, JapanCorrespondenc...

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Autores principales:	Okayasu H, Shinozaki T, Takano Y, Sugawara N, Fujii K, Yasui-Furukori N, Ozeki Y, Shimoda K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	antipsychotic drugs sudden cardiac death electrocardiogram qt prolongation qt dispersion t peak-to-end interval Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/98360ed2999d47d68f606dfec3079958
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spelling	oai:doaj.org-article:98360ed2999d47d68f606dfec30799582021-12-02T14:08:52ZEffects of Antipsychotics on Arrhythmogenic Parameters in Schizophrenia Patients: Beyond Corrected QT Interval1178-2021https://doaj.org/article/98360ed2999d47d68f606dfec30799582021-01-01T00:00:00Zhttps://www.dovepress.com/effects-of-antipsychotics-on-arrhythmogenic-parameters-in-schizophreni-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Hiroaki Okayasu,1 Takahiro Shinozaki,1 Yumiko Takano,1 Norio Sugawara,1 Kumiko Fujii,2 Norio Yasui-Furukori,1 Yuji Ozeki,2 Kazutaka Shimoda1 1Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan; 2Department of Psychiatry, Shiga University of Medical Science, Shiga, JapanCorrespondence: Hiroaki Okayasu Tel +81 282-86-1111Email hokayasu@dokkyomed.ac.jpPurpose: Antipsychotic drugs have been implicated as risk factors for QT prolongation, which is a predictor of sudden cardiac death. However, the QT interval is considered an imperfect marker for proarrhythmic risk. Recently, improved methods, namely, QT dispersion (QTD), QTD ratio (QTDR), T wave peak-to-end interval (Tp-e), Tp-e/QT ratio and Tp-e/QTc ratio, have been regarded as proarrhythmic risk markers. We attempted to reevaluate the risk of sudden cardiac death due to antipsychotics use by measuring these improved evaluation methods.Patients and Methods: We retrospectively evaluated QTc, QTD, QTDR, Tp-e, Tp-e/QT ratio and Tp-e/QTc ratio from the medical records of 410 patients with schizophrenia diagnosed by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, or 5th Edition. Information on drugs administered was obtained from medical records. We investigated the correlation between each index on ECG and medication, such as antipsychotics, prescribed to participants with linear regression analysis. We also compared each index between 235 healthy controls and 235 patients matched for age and sex.Results: Positive correlations between QTc and levomepromazine and brexpiprazole were identified. Levomepromazine and lithium were positively correlated with QTD. Levomepromazine, quetiapine, asenapine, clozapine and carbamazepine were positively correlated with QTDR. Levomepromazine, olanzapine, brexpiprazole and lithium were positively correlated with Tp-e. Olanzapine, brexpiprazole and lithium were positively correlated with the Tp-e/QT ratio. Olanzapine, brexpiprazole and lithium were positively correlated with Tp-e/QTc ratio. Significant differences in all indexes were noted between the patients and healthy controls.Conclusion: According to our results, the prediction of the risk of sudden cardiac death by each index was inconsistent. We should evaluate the predictive factor of ventricular arrhythmia according to various electrocardiogram indexes because QTc alone could not identify the risk of sudden cardiac death.Keywords: antipsychotic drugs, sudden cardiac death, electrocardiogram, QT prolongation, QT dispersion, T peak-to-end intervalOkayasu HShinozaki TTakano YSugawara NFujii KYasui-Furukori NOzeki YShimoda KDove Medical Pressarticleantipsychotic drugssudden cardiac deathelectrocardiogramqt prolongationqt dispersiont peak-to-end intervalNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 239-249 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	antipsychotic drugs sudden cardiac death electrocardiogram qt prolongation qt dispersion t peak-to-end interval Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	antipsychotic drugs sudden cardiac death electrocardiogram qt prolongation qt dispersion t peak-to-end interval Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Okayasu H Shinozaki T Takano Y Sugawara N Fujii K Yasui-Furukori N Ozeki Y Shimoda K Effects of Antipsychotics on Arrhythmogenic Parameters in Schizophrenia Patients: Beyond Corrected QT Interval
description	Hiroaki Okayasu,1 Takahiro Shinozaki,1 Yumiko Takano,1 Norio Sugawara,1 Kumiko Fujii,2 Norio Yasui-Furukori,1 Yuji Ozeki,2 Kazutaka Shimoda1 1Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan; 2Department of Psychiatry, Shiga University of Medical Science, Shiga, JapanCorrespondence: Hiroaki Okayasu Tel +81 282-86-1111Email hokayasu@dokkyomed.ac.jpPurpose: Antipsychotic drugs have been implicated as risk factors for QT prolongation, which is a predictor of sudden cardiac death. However, the QT interval is considered an imperfect marker for proarrhythmic risk. Recently, improved methods, namely, QT dispersion (QTD), QTD ratio (QTDR), T wave peak-to-end interval (Tp-e), Tp-e/QT ratio and Tp-e/QTc ratio, have been regarded as proarrhythmic risk markers. We attempted to reevaluate the risk of sudden cardiac death due to antipsychotics use by measuring these improved evaluation methods.Patients and Methods: We retrospectively evaluated QTc, QTD, QTDR, Tp-e, Tp-e/QT ratio and Tp-e/QTc ratio from the medical records of 410 patients with schizophrenia diagnosed by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, or 5th Edition. Information on drugs administered was obtained from medical records. We investigated the correlation between each index on ECG and medication, such as antipsychotics, prescribed to participants with linear regression analysis. We also compared each index between 235 healthy controls and 235 patients matched for age and sex.Results: Positive correlations between QTc and levomepromazine and brexpiprazole were identified. Levomepromazine and lithium were positively correlated with QTD. Levomepromazine, quetiapine, asenapine, clozapine and carbamazepine were positively correlated with QTDR. Levomepromazine, olanzapine, brexpiprazole and lithium were positively correlated with Tp-e. Olanzapine, brexpiprazole and lithium were positively correlated with the Tp-e/QT ratio. Olanzapine, brexpiprazole and lithium were positively correlated with Tp-e/QTc ratio. Significant differences in all indexes were noted between the patients and healthy controls.Conclusion: According to our results, the prediction of the risk of sudden cardiac death by each index was inconsistent. We should evaluate the predictive factor of ventricular arrhythmia according to various electrocardiogram indexes because QTc alone could not identify the risk of sudden cardiac death.Keywords: antipsychotic drugs, sudden cardiac death, electrocardiogram, QT prolongation, QT dispersion, T peak-to-end interval
format	article
author	Okayasu H Shinozaki T Takano Y Sugawara N Fujii K Yasui-Furukori N Ozeki Y Shimoda K
author_facet	Okayasu H Shinozaki T Takano Y Sugawara N Fujii K Yasui-Furukori N Ozeki Y Shimoda K
author_sort	Okayasu H
title	Effects of Antipsychotics on Arrhythmogenic Parameters in Schizophrenia Patients: Beyond Corrected QT Interval
title_short	Effects of Antipsychotics on Arrhythmogenic Parameters in Schizophrenia Patients: Beyond Corrected QT Interval
title_full	Effects of Antipsychotics on Arrhythmogenic Parameters in Schizophrenia Patients: Beyond Corrected QT Interval
title_fullStr	Effects of Antipsychotics on Arrhythmogenic Parameters in Schizophrenia Patients: Beyond Corrected QT Interval
title_full_unstemmed	Effects of Antipsychotics on Arrhythmogenic Parameters in Schizophrenia Patients: Beyond Corrected QT Interval
title_sort	effects of antipsychotics on arrhythmogenic parameters in schizophrenia patients: beyond corrected qt interval
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/98360ed2999d47d68f606dfec3079958
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Effects of Antipsychotics on Arrhythmogenic Parameters in Schizophrenia Patients: Beyond Corrected QT Interval

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