Abstract

Giriş Trisiklik antidepresan (TSA) zehirlenmesi, kardiyovasküler sistem dahil olmak üzere çeşitli sistemleri etkileyebilir. Son yıllarda, Tp-Te aralığı, Tp-Te dispersiyonu ve Tp-Te / QT gibi transmiyokardiyal repolarizasyon parametrelerinin artmış kardiyak aritmi riski ile ilişkili olduğu gösterilmiştir. Bu çalışmanın amacı, TSA intoksikasyonunun transmiyokardiyal repolarizasyon parametreleri üzerindeki etkisini değerlendirmektir. Yöntemler Bu çalışma, TSA intoksikasyonu için izlenen ve tedavi edilen 124 hasta (43 erkek ve 81 kadın) ve 37 gönüllü kontrolü içeren kesitsel bir çalışmadır. Başvuru anında, 6. saat ve 24. saatte hastaların elektrokardiyogramları değerlendirilerek Tp-Te ve QT intervali manuel olarak ölçülerek Tp-Te / QT oranı hesaplandı. Bulgular Çalışma grubunun yaş ortalaması 27.95 ± 7.72 idi. Hasta ve kontrol grupları arasında V2-6 derivasyonlarında Tp-Te (p <0.001), Tp-Te ortalaması (p <0,05) ve dağılımı (p <0,05) açısından istatistiksel olarak anlamlı fark vardı. V2-5 derivasyonlarında Tp-Te / QT değerlerinde anlamlı farklılık vardı (p <0,05). Hasta ve kontrol grupları arasında maksimum ve minimum QT değerleri, uzamış QTc, uzamış QTc dispersiyonu ve uzamış ortalama Tp-Te / QT değerlerinde istatistiksel olarak anlamlı fark bulundu (p <0,05); uzamış ortalama Tp-Te değerleri gruplar arasında benzerdi (p = 0,117). Tp-Te ve Tp-Te / QT verilerinin hastalığı öngörmedeki tanısal değerini araştırmak için yapılan ROC analizinde V2 derivasyonu dışındaki tüm derivasyonların tanısal olduğunu bulduk (p <0.05). Sonuç TSA intoksikasyonu, transmiyokardiyal repolarizasyon parametrelerini sağlıklı popülasyona göre anlamlı olarak artırmaktadır.

Keywords

• Trisiklik antidepresan zehirlenmesi
• Tp-Te aralığı
• QT aralığı
• Tp-Te / QT oranı
• elektrokardiyografi

Evaluation of the Changes in T Peak-T End Interval and T Peak-T End/QT Ratio in Tricyclic Antidepressant Intoxication

Abstract

Introduction Tricyclic antidepressant (TCA) intoxication can affect various systems including cardiovascular system. In recent years, the transmiyocardial repolarization parameters including T peak-Tend (Tp-Te) interval, Tp-Te dispersion and Tp-Te/QT have been shown to be associated with increased cardiac arrhythmia risk. The aim of this study was to evaluate the effect of TCA intoxication on transmyocardial repolarization parameters. Methods This study was a cross-sectional study including 124 patients (43 male and 81 female) who were followed up and treated for TCA intoxication and 37 volunteer controls. At admission, 6th hour and 24th hour, the electrocardiogram of the patients were evaluated and Tp-Te and QT interval were measured manually and Tp-Te/QT ratio was calculated. Results The mean age of the study group was 27.95±7.72. There were statistically significant difference in terms of Tp-e (p<0.001), Tp-Te mean (p<0,05) and dispersion (p <0,05) in V2-6 derivations between patient and control groups. There were significant difference in the Tp-Te/QT values in V2-5 derivations (p<0,05). We found a statistically significant difference in maximum and minimum QT values (p<0,001), prolonged QTc, prolonged QTc dispersion and prolonged mean Tp-Te/QT values between patient and control groups (p <0.05); prolonged mean Tp-Te values were similar between groups (p = 0,117). In the ROC analysis performed to investigate the diagnostic value of Tp-Te and Tp-Te/QT data in predicting disease, we found that all leads except V2 derivation were diagnostic (p <0.05). Conclusion TCA intoxication significantly increased the transmiyocardial repolarization parameters compared to the healthy population.

Keywords

• Tricyclic antidepressant intoxication
• Tp-Te interval
• QT interval
• Tp-Te/QT ratio
• electrocardiography

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