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https://www.readbyqxmd.com/read/28914976/haloperidol-versus-5-ht3-receptor-antagonists-for-postoperative-vomiting-and-qtc-prolongation-a-noninferiority-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#1
REVIEW
Preet Mohinder Singh, Anuradha Borle, Jeetinder Kaur Makkar, Anjan Trikha, David Fish, Ashish Sinha
Haloperidol is an antipsychotic with well-known antiemetic potential. It is underutilized for postoperative nausea vomiting due to reported corrected QT interval (QTc) prolongation. This meta-analysis evaluates its safety and efficacy as an antiemetic in the perioperative period. Trials comparing haloperidol to 5-HT3 -receptor antagonists (5-HT3 -RA) for 24 postoperative vomiting incidences published up to May 2017 were searched in the medical database. Comparisons were made for antiemetic efficiency variables (vomiting incidence, rescue antiemetic need, and patients with complete response) during early (until 6 hours) and late postoperative phases...
September 15, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28912840/the-relationship-between-insulin-sensitivity-and-heart-rate-corrected-qt-interval-in-patients-with-type-2-diabetes
#2
Xiao-Hua Yang, Jian-Bin Su, Xiu-Lin Zhang, Li-Hua Zhao, Feng Xu, Xue-Qin Wang, Xing-Bo Cheng
BACKGROUND: Reduced insulin sensitivity not only contributes to the pathogenesis of type 2 diabetes but is also linked to multiple metabolic risk factors and cardiovascular diseases (CVD). A prolonged heart rate-corrected QT interval (QTc interval) is related to ventricular arrhythmias and CVD mortality and exhibits a high prevalence among type 2 diabetes patients. The aim of the study was to investigate the relationship between insulin sensitivity and the QTc interval in patients with type 2 diabetes...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28912075/ventricular-repolarization-disturbances-after-high-dose-intravenous-methylprednisolone-theraphy
#3
Gokhan Altunbas, Murat Sucu, Orhan Zengin
OBJECTIVE: There are no randomized trials evaluating the effects of pulse steroid treatment on cardiac electrophysiologic functions. The data are limited only to case series. In this study, we sought to evaluate the effects of high dose intravenous methylprednisolone therapy on indices of ventricular repolarization. METHODS: Fifty patients with various autoimmune and inflammatory disorders were enrolled to the study. Electrocardiography (ECG) was obtained 4h before and 12h after the pulse steroid treatment...
August 1, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28904293/characteristics-of-electromechanical-window-in-anesthetized-rabbit-models-of-short-qt-and-long-qt-syndromes
#4
Vudhiporn Limprasutr, Nakkawee Saengklub, Pradtana Meedech, Anusak Kijtawornrat, Robert L Hamlin
The current regulatory guidelines recommend the use of QT interval to assess the risk of arrhythmogenic potential of new chemical entities. Recently, the electromechanical window (EMW), the difference in duration between electrical and mechanical systole, has been proposed as markers for drug-induced torsades de pointes (TdP); however, data of EMW in short QT model are not available. This study aimed to characterize the EMW as a marker for drug-induced ventricular arrhythmias in anesthetized rabbit model of long QT syndrome type 2 (LQT2) and short QT syndrome (SQTS) infused with reference compounds known to lengthen or shorten QT intervals...
2017: Journal of Toxicological Sciences
https://www.readbyqxmd.com/read/28903488/an-analysis-of-the-relationship-between-preclinical-and-clinical-qt-interval-related-data
#5
Christopher E Pollard, Matthew Skinner, Stanley E Lazic, Helen M Prior, Kelly M Conlon, Jean-Pierre Valentin, Corina Dota
There has been significant focus on drug-induced QT interval prolongation caused by block of the human ether-a-go-go-related gene (hERG)-encoded potassium channel. Regulatory guidance has been implemented to assess QT interval prolongation risk: preclinical guidance requires a candidate drug's potency as a hERG channel blocker to be defined and also its effect on QT interval in a non-rodent species; clinical guidance requires a "Thorough QT Study" during development, although some QT prolonging compounds are identified earlier via a Phase I study...
September 1, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28901586/long-term-effects-of-cardiac-resynchronization-therapy-on-electrical-remodeling-in-heart-failure-a-prospective-study
#6
Bharatraj Banavalikar, Anees Thajudeen, Narayanan Namboodiri, Krishna Kumar Mohanan Nair, Abhilash Srivilasam Pushpangadhan, Ajit Kumar Valaparambil
INTRODUCTION: Effects of cardiac resynchronization therapy (CRT) on arrhythmogenicity and sudden death have not been fully ascertained. CRT has been shown to increase transmural dispersion of repolarization (TDR) immediately on implantation, that may favorably remodel on long-term follow-up. However, such a hypothesis has not been prospectively evaluated. METHODS AND RESULTS: We included 35 consecutive patients who underwent CRT implantation between September 2013 & August 2014 (mean age 56...
September 13, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28900189/misalignment-with-the-external-light-environment-drives-metabolic-and-cardiac-dysfunction
#7
Alexander C West, Laura Smith, David W Ray, Andrew S I Loudon, Timothy M Brown, David A Bechtold
Most organisms use internal biological clocks to match behavioural and physiological processes to specific phases of the day-night cycle. Central to this is the synchronisation of internal processes across multiple organ systems. Environmental desynchrony (e.g. shift work) profoundly impacts human health, increasing cardiovascular disease and diabetes risk, yet the underlying mechanisms remain unclear. Here, we characterise the impact of desynchrony between the internal clock and the external light-dark (LD) cycle on mammalian physiology...
September 12, 2017: Nature Communications
https://www.readbyqxmd.com/read/28895173/cardiac-changes-in-moderately-malnourished-children-and-their-correlations-with-anthropometric-and-electrolyte-changes
#8
Osama El Razaky, Ahmed Naeem, Amr Donia, Doaa El Amrousy, Noha Elfeky
OBJECTIVE: To evaluate electrocardiographic and echocardiographic changes in moderately malnourished children and to correlate them with both anthropometric and electrolyte changes. PATIENTS AND METHOD: Sixty moderately malnourished children were taken as patient group, and 60 healthy children of matched age and sex were taken as control group. Weight, height, body mass index (BMI), serum albumin, and electrolytes were measured for all children. Electrocardiographic evaluation for calculated QT (QTc) and QT dispersion (QTd) was performed...
September 12, 2017: Echocardiography
https://www.readbyqxmd.com/read/28895028/prevalence-of-qt-interval-prolonging-drug-drug-interactions-qt-ddis-in-psychiatry-wards-of-tertiary-care-hospitals-in-pakistan-a-multicenter-cross-sectional-study
#9
Qasim Khan, Mohammad Ismail, Iqbal Haider, Fahadullah Khan
Background QT prolongation and associated arrhythmias, torsades de pointes (TdP), are considerable negative outcomes of many antipsychotic and antidepressant agents frequently used by psychiatric patients. Objective To identify the prevalence, levels, and predictors of QT prolonging drug-drug interactions (QT-DDIs), and AZCERT (Arizona Center for Education and Research on Therapeutics) classification of drugs involved in QT-DDIs. Setting Psychiatry wards of three major tertiary care hospitals of Khyber-Pakhtunkhwa, Pakistan...
September 12, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28894151/the-effects-of-ageing-and-adrenergic-challenge-on-electrocardiographic-phenotypes-in-a-murine-model-of-long-qt-syndrome-type-3
#10
Karan R Chadda, Shiraz Ahmad, Haseeb Valli, Ingrid den Uijl, Ali Bak Al-Hadithi, Samantha C Salvage, Andrew A Grace, Christopher L-H Huang, Kamalan Jeevaratnam
Long QT Syndrome 3 (LQTS3) arises from gain-of-function Nav1.5 mutations, prolonging action potential repolarisation and electrocardiographic (ECG) QT interval, associated with increased age-dependent risk for major arrhythmic events, and paradoxical responses to β-adrenergic agents. We investigated for independent and interacting effects of age and Scn5a+/ΔKPQ genotype in anaesthetised mice modelling LQTS3 on ECG phenotypes before and following β-agonist challenge, and upon fibrotic change. Prolonged ventricular recovery was independently associated with Scn5a+/ΔKPQ and age...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28892643/comparison-of-the-effects-of-i-sub-k-ach-sub-i-sub-kr-sub-and-i-sub-na-sub-block-in-conscious-dogs-with-atrial-fibrillation-and-on-action-potentials-in-remodeled-atrial-trabeculae
#11
Viktor Juhász, Tibor Hornyik, Attila Benák, Norbert Nagy, Zoltan Husti, Robert Pap, László Sághy, László Virág, András Varró, István Baczkó
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a major cause of morbidity and mortality. Traditional antiarrhythmic agents used for restoration of sinus rhythm have limited efficacy in long-term AF and they may possess ventricular proarrhythmic adverse effects, especially in patients with structural heart disease. The acetylcholin receptor-activated potassium channel (I<sub>K,ACh</sub>) represents an atrial-selective target for future AF management. We investigated the effects of the I<sub>K,ACh</sub> blocker tertiapin-Q (TQ), a derivative of the honeybee toxin tertiapin, on chronic atrial tachypacing induced AF in conscious dogs, without the influence of anesthetics that modulate a number of cardiac ion channels...
September 11, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28892227/dynamic-changes-of-qtc-interval-and-prognostic-significance-in-takotsubo-stress-cardiomyopathy
#12
Francesco Santoro, Natale Daniele Brunetti, Nicola Tarantino, Jorge Romero, Francesca Guastafierro, Armando Ferraretti, Luigi F M Di Martino, Riccardo Ieva, Pier Luigi Pellegrino, Matteo Di Biase, Luigi Di Biase
BACKGROUND: Prolonged QT corrected (QTc) intervals are associated with adverse cardiovascular outcomes both in healthy and high-risk populations. Our objective was to evaluate the QTc intervals during a takotsubo cardiomyopathy (TTC) episodes and their potential prognostic role. HYPOTHESIS: Dynamic changes of QTc interval during hospitalization for TTC could be associated with outcome at follow-up. METHODS: Fifty-two consecutive patients hospitalized for TTC were enrolled...
September 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28888367/attenuation-of-ischemia-reperfusion-induced-inhibition-of-the-rapid-component-of-delayed-rectifier-potassium-current-by-isosteviol-through-scavenging-reactive-oxygen-species
#13
Chunxia Yin, Yaoxu Chen, Huanlin Wu, Danping Xu, Wen Tan
Isosteviol has been demonstrated to play a protective role during ischemia reperfusion (I/R) myocardial infarction. However, the underlying electrophysiological mechanisms of isosteviol are still unknown. Our previous study showed that the rapid component of the delayed rectifier potassium channel (IKr) plays an important role in the prolongation of I/R-induced QT interval-related arrhythmia. This study aimed to investigate whether isosteviol could attenuate I/R-induced prolongation of the action potential duration (APD) along with inhibition of IKr, and we aimed to clarify the electrophysiological mechanism of isosteviol to determine its cardioprotective effects in guinea pigs...
September 6, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28866768/providers-response-to-clinical-decision-support-for-qt-prolonging-drugs
#14
Sunita Sharma, J Martijn Bos, Robert F Tarrell, Gyorgy J Simon, Bruce W Morlan, Michael J Ackerman, Pedro J Caraballo
Commonly used drugs in hospital setting can cause QT prolongation and trigger life-threatening arrhythmias. We evaluate changes in prescribing behavior after the implementation of a clinical decision support system to prevent the use of QT prolonging medications in the hospital setting. We conducted a quasi-experimental study, before and after the implementation of a clinical decision support system integrated in the electronic medical record (QT-alert system). This system detects patients at risk of significant QT prolongation (QTc>500ms) and alerts providers ordering QT prolonging drugs...
September 2, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28862317/is-prolongation-of-corrected-qt-interval-associated-with-seizures-induced-by-electroconvulsive-therapy-reduced-by-atropine-sulfate
#15
Yoko Suzuki, Miho Miyajima, Katsuya Ohta, Noriko Yoshida, Rie Omoya, Mayo Fujiwara, Takafumi Watanabe, Masaki Okumura, Hiroaki Yamazaki, Masayuki Shintaku, Issei Murata, Shigeru Ozaki, Takeshi Sasaki, Mitsuru Nakamura, Hiroshi Suwa, Tetsuo Sasano, Tokuhiro Kawara, Masato Matsuura, Eisuke Matsushima
BACKGROUND: Electrocardiogram abnormalities have been reported during electroconvulsive therapy (ECT). A corrected QT interval (QTc) prolongation indicates delayed ventricular repolarization, which can trigger ventricular arrhythmias such as torsade de pointes (TdP). We examined the QTc changes during generalized tonic-clonic seizures induced by ECT, and the effects of atropine sulfate on these QTc changes. METHODS: We analyzed heart rate, QT interval, and QTc in 32 patients with depression who underwent ECT (25 women, 67...
September 1, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28861149/posttranslational-modifications-of-calcium-calmodulin-dependent-protein-kinase-ii%C3%AE-and-its-downstream-signaling-in-human-failing-hearts
#16
Tomas Rajtik, Eva Goncalvesova, Zoltan V Varga, Przemyslaw Leszek, Mariusz Kusmierczyk, Michal Hulman, Jan Kyselovic, Peter Ferdinandy, Adriana Adameova
BACKGROUND: In human failing hearts (HF) of different origin (coronary artery disease-CAD, dilated-DCM, restrictive and hypertrophic cardiomyopathy-OTHER), we investigated the active forms of Ca(2+)/calmodulin-dependent protein kinase IIδ (p-Thr(287)-CaMKIIδ, oxMet(281/282)-CaMKIIδ) and their role in phenotypes of the disease. METHODS AND RESULTS: Although basic diagnostic and clinical markers indicating the attenuated cardiac contractility and remodeling were comparable in HF groups, CaMKIIδ-mediated axis was different...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28858825/erratum-genome-wide-association-study-of-susceptibility-to-particulate-matter-associated-qt-prolongation
#17
Rahul Gondalia, Christy L Avery, Melanie D Napier, Raúl Méndez-Giráldez, James D Stewart, Colleen M Sitlani, Yun Li, Kirk C Wilhelmsen, Qing Duan, Jeffrey Roach, Kari E North, Alexander P Reiner, Zhu-Ming Zhang, Lesley F Tinker, Jeff D Yanosky, Duanping Liao, Eric A Whitsel
[This corrects the article DOI: 10.1289/EHP347.].
August 24, 2017: Environmental Health Perspectives
https://www.readbyqxmd.com/read/28856762/pregbalin-induced-recurrent-syncopal-attacks-with-prolong-qt-interval
#18
Adem Adar, Fahri Cakan, Orhan Önalan
Long QT syndrome may lead to fatal dysrhythmia. Prolongation of QT interval due to pregabalin has been shown in rats and no data is available in humans. We report a 80-year-old female patient using pregabalin. She was presented to emergency room with syncope attacks. Her admission electrocardiography demonstrated prolonged QT interval. After excluding the possible causes of the long QT syndrome, we attributed prolonged QT interval to pregabalin therapy. After discontinuation of pregabalin QT interval returned to normal range and patient experienced no further syncope attacks...
August 30, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28855948/astragalus-granule-prevents-ca-2-current-remodeling-in-heart-failure-by-the-downregulation-of-camkii
#19
Sinai Li, Yibing Nong, Qun Gao, Jing Liu, Yan Li, Xiaoyun Cui, Jie Wan, Jinjin Lu, Mingjie Sun, Qian Wu, Xiaolu Shi, Haifeng Cui, Weihong Liu, Mingxue Zhou, Lina Li, Qian Lin
BACKGROUND: Astragalus was broadly used for treating heart failure (HF) and arrhythmias in East Asia for thousands of years. Astragalus granule (AG), extracted from Astragalus, shows beneficial effect on the treatment of HF in clinical research. We hypothesized that administration of AG prevents the remodeling of L-type Ca(2+) current (ICa-L) in HF mice by the downregulation of Ca(2+)/calmodulin-dependent protein kinase II (CaMKII). METHODS: HF mice were induced by thoracic aortic constriction (TAC)...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28855066/emergency-department-approach-to-qtc-prolongation
#20
REVIEW
Ali Pourmand, Maryann Mazer-Amirshahi, Sonya Chistov, Youssef Sabha, Damir Vukomanovic, Mohammed Almulhim
QTc prolongation has been associated with increased risk of developing ventricular tachydysrhythmias, particularly Torsades de Pointes (TdP). QTc prolongation is influenced by many factors including congenital causes, heart rate, metabolic imbalances, and pharmacotherapy. Several commonly used medications in the emergency department (ED), such as antipsychotics and antiemetics, are known to prolong the QT interval. In addition, ED patients may present with conditions that may predispose them to QTc prolongation, such as drug overdose or hypokalemia, which can further complicate management...
August 24, 2017: American Journal of Emergency Medicine
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