Morphological Changes
of Electric Heart Field in Patients Suffering from Depressive Disorder and Treated with Dosulepin.
Kitzlerová E., Kittnar O.1, Paclt I., Slavíček J.1, Anders M., Dohnalová A.1
Psychiatrická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. J. Raboch, DrSc. Fyziologický ústav 1. LF UK, Praha, |
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Summary:
The cardio-toxic effects of therapeutic plasma levels of TCA (150 – 200 ng/ml in serum) are not
quite so evident. New information about it bring the device of Cardiag 112.2, which can measure
simultaneously the ECG (electrocardiography), VCG (vectorcardiography) and BSPM (method of
body surface potential mapping). With this device we made 2 studies.
In the fi rst one, we tried to prove if in depressive patients in remission, treated with prophylactic
doses of dosulepine, are some statistically signifi cant changes in ECG parameters in dependence with
dosulepine plasma levels. 4 electrocardiological parameters were proven to correlate signifi cantly
with dosulepine plasma levels: QRS axis deviation in frontal plane (by the method of VCG) (p < 0,01),
the maximal positive value of the isointegral map during the fi rst 40 ms of the QRS complex, the so
called DIAM40max (by the method of BSPM) (p < 0,05) and QRS-STT vectors plane angles in transversal
and in left sagittal planes (by the method of VCG) (p < 0,05).
In the second one, we measured the dispersion of QT interval in depressive patients treated with
dosulepine (by the method of BSPM) and than we correlated the QTd with dosulepine plasma levels.
It was suggested as was by many authors, that dispersion of the QT interval (QTd) is a non specifi c
sign of a changed course of repolarization, which refl ects the cardiotoxic side effects of dosulepin
and that it could be used also as a simple marker for the elevated plasma level of dosulepin on the
myocardium at therapeutic or prophylactic plasma levels.
The antidepressant of dosulepine is potentially dangerous in inducing of the cardiac arrhytmias in
depressive patients without cardiac diseases, and this cardiovascular risk is in the correlation with
dosulepine plasma levels.
Key words:
dosulepine, cardiotoxicity, body potential surface mapping, plasma levels.
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