The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19

Yıl: 2022 Cilt: 27 Sayı: 1 Sayfa Aralığı: 112 - 118 Metin Dili: İngilizce DOI: 10.5505/ejm.2022.26539 İndeks Tarihi: 17-05-2023

The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19

Öz:
JT and JTp intervals are among the ventricular repolarization parameters and prolongation, just as the QT interval is related to ventricular arrhythmias. This study aims to examine the effect of hydroxychloroquine on JTc and JTpc intervals in individuals hospitalized with COVID-19. We involved 130 COVID-19 patients divided into two groups as the hydroxychloroquine treatment group and the control group, in this study. ECGs of the patients were recorded at admission and after a median of 48 hours following the initiation of hydroxychloroquine treatment. Then, QTc, JTc, and JTpc intervals were measured. Patients’ average age was 48 (37-66 IQR), and 53% of the individuals were female. The median basal JTpc interval was 215 ms(195-230 IQR), while JTpc-Day 3 was 220 ms(195-238 IQR). The median basal JTc interval was 320 ms(301-334 IQR), while JTc-Day 3 was 328 ms(306-343 IQR). JTpc and JTc interval in the hydroxychloroquine group have prolonged significantly (p<0.001), while there were no significant changes in the control group for both values (p>0.05). There was a significant prolongation in the multivariable linear regression analysis in JTc-Day 3 and JTpc-Day 3 after hydroxychloroquine treatment. (ß=-2.589, 95%CI, 2.384-17.894, p=0.011, ß=2.195, 95%CI, 759-14.752, p=0.030, respectively). In this study, we found significant prolongation in JTc and JTpc intervals in the patients who take hydroxychloroquine treatment.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020; 323: 1239-1242.
  • 2. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19—11 March 2020. https://www.who.int/dg/speeches/detail/who-directorgeneral-s-opening-remarks-at-the-media-briefing-on-covid19—11-march-2020. Accessed March 24, 2020.
  • 3. World Health Organization. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-theinternational-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov). Accessed March 24, 2020.
  • 4. Mitrani RD, Dabas N, Goldberger JJ. COVID-19 cardiac injury: Implications for long-term surveillance and outcomes in survivors. Heart Rhythm 2020; 17: 1984-1990.
  • 5. Kang Y, Chen T, Mui D,at al. Cardiovascular manifestations and treatment considerations in COVID-19. Heart 2020; 106: 1132-1141.
  • 6. Mercuro NJ, Yen CF, Shim DJ, at al. Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19). JAMA Cardiol 2020; 5: 1036-1041.
  • 7. Cortegiani A, Ingoglia G, Ippolito M, Giarratano A, Einav S. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. J Crit Care 2020; 57: 279-283.
  • 8. World Health Organization. The cardiotoxicity of antimalarials: Malaria Policy Advisory Committee Meeting. Published March 24 2017.https://www.who.int/malaria/mpac/mpac-mar2017-erg-cardiotoxicity-report-session2;
  • 9. Priori SG, Aliot E, Blømstrom-Lundqvist C, et al.. Task Force on Sudden Cardiac Death, European Society of Cardiology. Europace. 2002; 4: 3-18.
  • 10. Murabayashi T, Fetics B, Kass D, Nevo E, Gramatikov B, Berger RD. Beat-to-beat QT interval variability associated with acute myocardial ischemia. J Electrocardiol 2002; 35: 19-25.
  • 11. Rautaharju PM, Surawicz B, Gettes LS, at al; American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; American College of Cardiology Foundation; Heart Rhythm Society. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol 2009; 53: 982-991.
  • 12. Johannesen L, Vicente J, Mason JW, Sanabria C, Waite-Labott K, Hong M, Guo P, Lin J, Sørensen JS, Galeotti L, Florian J, Ugander M, Stockbridge N, Strauss DG. Differentiating drug-induced multichannel block on the electrocardiogram: randomized study of dofetilide, quinidine, ranolazine, and verapamil. Clin Pharmacol Ther 2014; 96: 549-558.
  • 13. Johannesen L, Vicente J, Gray RA,at al. Improving the assessment of heart toxicity for all new drugs through translational regulatory science. Clin Pharmacol Ther 2014; 95: 501-508.
  • 14. Bone RC, Balk RA, Cerra FB,at al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101: 1644-1655.
  • 15. Fan Y, Guo T, Lu Z. Myocardial Injury in COVID-19-Can We Successfully Target Inflammation?-Reply. JAMA Cardiol 2020; 5: 1070-1071.
  • 16. Tönnesmann E, Kandolf R, Lewalter T. Chloroquine cardiomyopathy - a review of the literature. Immunopharmacol Immunotoxicol 2013; 35: 434-442.
  • 17. Naqvi TZ, Luthringer D, Marchevsky A, Saouf R, Gul K, Buchbinder NA. Chloroquine-induced cardiomyopathy-echocardiographic features. J Am Soc Echocardiogr 2005;
  • 18: 383-387. 18. Naksuk N, Lazar S, Peeraphatdit TB. Cardiac safety of off-label COVID-19 drug therapy: a review and proposed monitoring protocol. Eur Heart J Acute Cardiovasc Care 2020; 9: 215-221.
  • 19. Oikarinen L, Toivonen L, Viitasalo M. Electrocardiographic measures of ventricular repolarisation dispersion in patients with coronary artery disease susceptible to ventricular fibrillation. Heart 1998; 79: 554-559.
  • 20. Fenichel RR, Malik M, Antzelevitch C, at al; Independent Academic Task Force. Drug-induced torsades de pointes and implications for drug development. J Cardiovasc Electrophysiol 2004; 15: 475-495.
  • 21. Johannesen L, Vicente J, Mason JW, at al. Late sodium current block for drug-induced long QT syndrome: Results from a prospective clinical trial. Clin Pharmacol Ther 2016; 99: 214-223.
  • 22. Vicente J, Johannesen L, Mason JW, Crumb WJ, Pueyo E, Stockbridge N, Strauss DG. Comprehensive T wave morphology assessment in a randomized clinical study of dofetilide, quinidine, ranolazine, and verapamil. J Am Heart Assoc 2015; 4: e001615.
  • 23. Crow RS, Hannan PJ, Folsom AR. Prognostic significance of corrected QT and corrected JT interval for incident coronary heart disease in a general population sample stratified by presence or absence of wide QRS complex: the ARIC Study with 13 years of follow-up. Circulation 2003; 108: 1985-1989.
  • 24. Bihlmeyer NA, Brody JA, Smith AV,at al. ExomeChip-Wide Analysis of 95 626 Individuals Identifies 10 Novel Loci Associated With QT and JT Intervals. Circ Genom Precis Med 2018; 11: e001758.
  • 25. Bonnemeier H, Hartmann F, Wiegand UK, Bode F, Katus HA, Richardt G. Course and prognostic implications of QT interval and QT interval variability after primary coronary angioplasty in acute myocardial infarction. J Am Coll Cardiol 2001; 37: 44-50.
  • 26. Vrtovec B, Starc V, Starc R. Beat-to-beat QT interval variability in coronary patients. J Electrocardiol 2000; 33: 119-125.
  • 27. Vrtovec B, Starc V, Meden-Vrtovec H. The effect of estrogen replacement therapy on ventricular repolarization dynamics in healthy postmenopausal women. J Electrocardiol 2001; 34: 277-283.
  • 28. Oikarinen L, Viitasalo M, Toivonen L. Dispersions of the QT interval in postmyocardial infarction patients presenting with ventricular tachycardia or with ventricular fibrillation. Am J Cardiol 1998; 81: 694-697.
APA Bilge Ö, Çap M, Işık F, Altindag R, Akyüz A, İNCİ Ü, Aslan B, Kaya İ, Adıyaman M, Aladağ N, Akın H, Altıntaş B (2022). The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. , 112 - 118. 10.5505/ejm.2022.26539
Chicago Bilge Önder,Çap Murat,Işık Ferhat,Altindag Rojhat,Akyüz Abdurrahman,İNCİ ÜMİT,Aslan Burhan,Kaya İlyas,Adıyaman Mehmet Şahin,Aladağ Nesim,Akın Halil,Altıntaş Bernas The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. (2022): 112 - 118. 10.5505/ejm.2022.26539
MLA Bilge Önder,Çap Murat,Işık Ferhat,Altindag Rojhat,Akyüz Abdurrahman,İNCİ ÜMİT,Aslan Burhan,Kaya İlyas,Adıyaman Mehmet Şahin,Aladağ Nesim,Akın Halil,Altıntaş Bernas The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. , 2022, ss.112 - 118. 10.5505/ejm.2022.26539
AMA Bilge Ö,Çap M,Işık F,Altindag R,Akyüz A,İNCİ Ü,Aslan B,Kaya İ,Adıyaman M,Aladağ N,Akın H,Altıntaş B The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. . 2022; 112 - 118. 10.5505/ejm.2022.26539
Vancouver Bilge Ö,Çap M,Işık F,Altindag R,Akyüz A,İNCİ Ü,Aslan B,Kaya İ,Adıyaman M,Aladağ N,Akın H,Altıntaş B The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. . 2022; 112 - 118. 10.5505/ejm.2022.26539
IEEE Bilge Ö,Çap M,Işık F,Altindag R,Akyüz A,İNCİ Ü,Aslan B,Kaya İ,Adıyaman M,Aladağ N,Akın H,Altıntaş B "The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19." , ss.112 - 118, 2022. 10.5505/ejm.2022.26539
ISNAD Bilge, Önder vd. "The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19". (2022), 112-118. https://doi.org/10.5505/ejm.2022.26539
APA Bilge Ö, Çap M, Işık F, Altindag R, Akyüz A, İNCİ Ü, Aslan B, Kaya İ, Adıyaman M, Aladağ N, Akın H, Altıntaş B (2022). The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. Eastern Journal of Medicine, 27(1), 112 - 118. 10.5505/ejm.2022.26539
Chicago Bilge Önder,Çap Murat,Işık Ferhat,Altindag Rojhat,Akyüz Abdurrahman,İNCİ ÜMİT,Aslan Burhan,Kaya İlyas,Adıyaman Mehmet Şahin,Aladağ Nesim,Akın Halil,Altıntaş Bernas The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. Eastern Journal of Medicine 27, no.1 (2022): 112 - 118. 10.5505/ejm.2022.26539
MLA Bilge Önder,Çap Murat,Işık Ferhat,Altindag Rojhat,Akyüz Abdurrahman,İNCİ ÜMİT,Aslan Burhan,Kaya İlyas,Adıyaman Mehmet Şahin,Aladağ Nesim,Akın Halil,Altıntaş Bernas The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. Eastern Journal of Medicine, vol.27, no.1, 2022, ss.112 - 118. 10.5505/ejm.2022.26539
AMA Bilge Ö,Çap M,Işık F,Altindag R,Akyüz A,İNCİ Ü,Aslan B,Kaya İ,Adıyaman M,Aladağ N,Akın H,Altıntaş B The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. Eastern Journal of Medicine. 2022; 27(1): 112 - 118. 10.5505/ejm.2022.26539
Vancouver Bilge Ö,Çap M,Işık F,Altindag R,Akyüz A,İNCİ Ü,Aslan B,Kaya İ,Adıyaman M,Aladağ N,Akın H,Altıntaş B The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19. Eastern Journal of Medicine. 2022; 27(1): 112 - 118. 10.5505/ejm.2022.26539
IEEE Bilge Ö,Çap M,Işık F,Altindag R,Akyüz A,İNCİ Ü,Aslan B,Kaya İ,Adıyaman M,Aladağ N,Akın H,Altıntaş B "The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19." Eastern Journal of Medicine, 27, ss.112 - 118, 2022. 10.5505/ejm.2022.26539
ISNAD Bilge, Önder vd. "The Effect of Hydroxychloroquine On Ventricular Repolarization Parameters Jtc And Jtpc Intervals In Patients With Covid-19". Eastern Journal of Medicine 27/1 (2022), 112-118. https://doi.org/10.5505/ejm.2022.26539