Assessment of autonomic dysfunction in Parkinson patients by electrocardiogram / Parkinson hastalarında otonomik disfonksiyonun EKG ile değerlendirilmesi

TÜRK, Adem; Koksal, Ayhan; Altıokka, Özlem; Karademir, Fazilet; Dırıcan, Ayten Ceyhan; Altunkaynak, Yavuz; Yazar, Tamer; Baybaş, Sevim

doi:10.5350/dajpn2012250207

Cited by 2 publications

(3 citation statements)

References 13 publications

(17 reference statements)

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“… 54 , 55 The risk of QTc prolongation is increased with the presence of autonomic dysfunction, comorbidities (eg, heart disease, congestive heart failure, myocardial infarction, left ventricular dysfunction, arrhythmia, liver disease, septic shock, thyroid disease), electrolyte imbalance, polypharmacy, increased age, female sex, and genetic variation. 12 , 51 , 53 , 117 , 122 , 130 , 143 , 144 Symptomatic cardiac arrhythmias, congenital QT interval prolongation, hypomagnesemia, and hypokalemia are particular risk factors for further QT prolongation. In the PD population, autonomic dysfunction, comorbidities (eg, heart, liver, or endocrine conditions), polypharmacy, and older age are common, 12 , 145–147 and PD occurs at a slightly higher frequency in males than females (1.6:1).…”

Section: Discussionmentioning

confidence: 99%

“… 12 , 51 , 53 , 117 , 122 , 130 , 143 , 144 Symptomatic cardiac arrhythmias, congenital QT interval prolongation, hypomagnesemia, and hypokalemia are particular risk factors for further QT prolongation. In the PD population, autonomic dysfunction, comorbidities (eg, heart, liver, or endocrine conditions), polypharmacy, and older age are common, 12 , 145–147 and PD occurs at a slightly higher frequency in males than females (1.6:1). 148 …”

Section: Discussionmentioning

confidence: 99%

“… 8–10 Myocardial denervation has been observed in patients early in the course of PD disease and can lead to corrected QT interval (QTc) prolongation. 11 Prolongation occurs regardless of comorbidities or coadministration of QTc-prolonging medications 9 , 12 and appears to worsen with PD severity and age. 13 QTc prolongation >500 ms is particularly dangerous, as it can lead to arrhythmias, including Torsade de pointes (TdP), which is associated with sudden cardiac death.…”

Section: Introductionmentioning

confidence: 99%

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QTc Interval Prolongation with Therapies Used to Treat Patients with Parkinson’s Disease Psychosis: A Narrative Review

Torres‐Yaghi

Carwin

Carolan

et al. 2021

NDT

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In addition to the classic motor symptoms of Parkinson’s disease (PD), people with PD frequently experience nonmotor symptoms that can include autonomic dysfunction and neuropsychiatric symptoms such as PD psychosis (PDP). Common patient characteristics, including older age, use of multiple medications, and arrhythmias, are associated with increased risk of corrected QT interval (QTc) prolongation, and treatments for PDP (antipsychotics, dementia medications) may further increase this risk. This review evaluates how medications used to treat PDP affect QTc interval from literature indexed in the PubMed and Embase databases. Although not indicated for the treatment of psychosis, dementia therapies such as donepezil, rivastigmine, memantine, and galantamine are often used with or without antipsychotics and have minimal effects on QTc interval. Among the antipsychotics, data suggesting clinically meaningful QTc interval prolongation are limited. However, many antipsychotics have other safety concerns. Aripiprazole, olanzapine, and risperidone negatively affect motor function and are not recommended for PDP. Quetiapine is often sedating, can exacerbate underlying neurogenic orthostatic hypotension, and may prolong the QTc interval. Pimavanserin was approved by the US Food and Drug Administration (FDA) in 2016 and remains the only FDA-approved medication available to treat hallucinations and delusions associated with PDP. However, pimavanserin can increase QTc interval by approximately 5–8 ms. The potential for QTc prolongation should be considered in patients with symptomatic cardiac arrhythmias and those receiving QT-prolonging medications. In choosing a medication to treat PDP, expected efficacy must be balanced with potential safety concerns for individual patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

QTc Interval Prolongation with Therapies Used to Treat Patients with Parkinson’s Disease Psychosis: A Narrative Review

Torres‐Yaghi

Carwin

Carolan

et al. 2021

NDT

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Prevalence of QTc Prolongation in Patients with Parkinson’s Disease. Assessment of the Effects of Drugs, Clinical Risk Factors and Used Correction Formula

Malkiewicz

Siuda

2021

JCM

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Background: Parkinson’s disease (PD) is a possible risk factor for corrected QT interval (QTc) prolongation. PD patients frequently take QTc-prolonging drugs. The aim of the study was to assess the prevalence of QTc prolongation in PD and the influence of drugs and other potential risk factors on the QTc length in PD. Methods: 101 patients with PD and a good quality ECG were included in the study. The prolonged QTc was defined as ≥450 ms for men and ≥460 ms for women. Bazett’s (QTcB) and Framingham (QTcF) formulas were utilized to calculate QTc. Data about sex, age, PD duration, disease’s severity, comorbidities and QTc-prolonging drugs were collected. Multiple linear regressions with backward elimination were used to assess factors influencing the QTc. Results: A long QTc was presented in 13 patients (12.9%) for QTcB and 4 patients (4%) for QTcF. Longer QTc in PD patients was associated with older age, male sex and QTc-prolonging drugs regardless of the used formula. The QTcB was also significantly affected by the heart rate (HR). Conclusion: QTc prolongation is common in PD. Age, drugs and male gender are potential risk factors for QTc prolongation in PD.

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Assessment of autonomic dysfunction in Parkinson patients by electrocardiogram / Parkinson hastalarında otonomik disfonksiyonun EKG ile değerlendirilmesi

Cited by 2 publications

References 13 publications

QTc Interval Prolongation with Therapies Used to Treat Patients with Parkinson’s Disease Psychosis: A Narrative Review

QTc Interval Prolongation with Therapies Used to Treat Patients with Parkinson’s Disease Psychosis: A Narrative Review

Prevalence of QTc Prolongation in Patients with Parkinson’s Disease. Assessment of the Effects of Drugs, Clinical Risk Factors and Used Correction Formula

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