Acute psychosis leads to increased QT variability in patients suffering from schizophrenia

Bär, Karl‐Jürgen; Koschke, Mandy; Boettger, Michael Karl; Berger, Sandy; Kabisch, Alexander; Sauer, Heinrich; Voss, Andreas; Yeragani, Vikram K.

doi:10.1016/j.schres.2007.05.034

Cited by 83 publications

(54 citation statements)

References 44 publications

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“…by guest on June 6, 2016 http://ijnp.oxfordjournals.org/ (Bär et al 2007), probably due to disturbance in cortical-subcortical circuits that modulate autonomic function (Valkonen-Korhonen et al 2003). Physical deconditioning and concomitant medications may also contribute to the higher heart rate (Vancampfort et al 2011).…”

Section: Qtc Interval Variability In Schizophrenia 1537mentioning

confidence: 99%

“…Hypokalaemia, hypomagnesaemia and hypocalcaemia which are often found during acute psychotic episodes (Lam et al 2009) and autonomic changes like sympathetic overactivity and decreased vagal tone during agitation, may also affect cardiac repolarization in patients with schizophrenia (Bär et al 2007 ;Magnano et al 2002). Thus, the baseline QTc interval in patients with schizophrenia depends on the interplay between these factors (Alexander et al 1979 ;Rettenbacher et al 2005).…”

Section: Qtc Interval Variability In Schizophrenia 1537mentioning

confidence: 99%

“…Besides coronary artery disease, drug abuse, cigarette smoking, hypercholesterolaemia, hypertension, obesity and diabetes mellitus which are more common in patients with schizophrenia (Bär et al 2007 ;Glassman & Bigger, 2001 ;Hennekens et al 2005), recent articles have highlighted the association between prolonged QT interval on the ECG and increased risk of sudden death in patients with schizophrenia (Glassman & Bigger, 2001 ;Nielsen et al 2011). QT prolongation is a non-invasive biomarker of abnormal cardiac repolarization.…”

Section: Introductionmentioning

confidence: 99%

“…The QT interval may also be prolonged by autonomic changes, widened QRS complex in the ECG or electrolyte disturbances which are seen during acute psychotic episodes (Bär et al 2007 ;CSISG, 2002). However, some important questions about the QTc interval (QT interval corrected for the effect of heart rate) in patients with schizophrenia remain unanswered.…”

Section: Introductionmentioning

confidence: 99%

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QTc interval and its variability in patients with schizophrenia and healthy subjects: implications for a thorough QT study

Hingorani

Karnad

Natekar

et al. 2012

Int. J. Neuropsychopharm.

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We compared heart rate-corrected QT interval (QTc) and its within- and between-subject variability, in ECGs recorded several days apart for 207 patients with schizophrenia (age range 19-60 yr) with age- and gender-matched healthy controls. Patients had higher heart rates (mean±s.d.) than controls [75±15 beats per minute (bpm) vs. 63±10 bpm; p<0.0001]. QTc by Bazett's formula (QTcB) overestimated QTc interval at high heart rates; consequently QTcB was longer in patients (412±24 ms) than in controls (404±24 ms; p=0.0003). QTc by Fridericia's method (QTcF), which was not influenced by heart rate, was comparable (398±22 ms in patients vs. 401±19 ms in controls; p=0.17). Between-subject variability in QTcF was similar in patients (17 ms) and controls (16.2 ms) but within-subject variability was larger (13.1 ms vs. 10 ms, respectively). Thus, a larger sample size is required when thorough QTc studies with a cross-over design are performed in patients with schizophrenia than in healthy subjects; sample size is not increased for studies with a parallel design. Last, QTcF is preferred over QTcB in schizophrenia patients with higher heart rates.

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Section: Qtc Interval Variability In Schizophrenia 1537mentioning

confidence: 99%

Section: Qtc Interval Variability In Schizophrenia 1537mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

QTc interval and its variability in patients with schizophrenia and healthy subjects: implications for a thorough QT study

Hingorani

Karnad

Natekar

et al. 2012

Int. J. Neuropsychopharm.

View full text Add to dashboard Cite

show abstract

“…These changes include increased platelet reactivity, endothelial dysfunction, hypercortisolemia, autonomic dysfunction, decreased heart rate variability (HRV), and abnormal immune system activation [61,92,[110][111][112][113][114][115][116][117][118]. These pathophysiologic processes, commonly seen in patients with mental illness, promote heart disease via proatherogenic, pro-ischemic and pro-arrhythmic mechanisms.…”

Section: Pathophysiological Mechanismsmentioning

confidence: 99%