Research Article
BibTex RIS Cite
Year 2022, Volume: 39 Issue: 2, 472 - 476, 18.03.2022

Abstract

References

  • 1- Cipriani A, Zorzi A, Ceccato D, Capone F, Parolin M, Donato F, et al. Arrhythmic profile and 24-hour QT interval variability in COVID-19 patients treated with HCQ and azithromycin. Int J Cardiol. 2020;316:280-284. doi:10.1016/j.ijcard.2020.05.036.
  • 2- Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. HCQ and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020;56(1):105949. doi:10.1016/j.ijantimicag.2020.105949.
  • 3- Jankelson L, Karam G, Becker ML, Chinitz LA, Tsai MC. QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or HCQ as used in COVID-19: A systematic review. Heart Rhythm. 2020;17(9):1472-1479. doi:10.1016/j.hrthm.2020.05.008.
  • 4- Ozturk O, Ozturk U, Nergiz S, Karahan MZ. The Relationship between Angiotensin-II Type 1 Receptor Gene Polymorphism and Repolarization Parameters after a First Anterior Acute Myocardial Infarction. Korean Circ J. 2016;46(6):791-797. doi:10.4070/kcj.2016.46.6.791.
  • 5- Ozturk U, Ozturk O. Relation between index of cardioelectrophysiological balance and stroke severity in patients with acute ischemic stroke. Niger J Clin Pract. 2020;23(6):768-774. doi:10.4103/njcp.njcp_505_19.
  • 6- Robyns T, Lu HR, Gallacher DJ, Garweg C, Ector J, Willems R, et al. Evaluation of Index of Cardio-Electrophysiological Balance (iCEB) as a New Biomarker for the Identification of Patients at Increased Arrhythmic Risk. Ann Noninvasive Electrocardiol. 2016;21(3):294-304. doi:10.1111/anec.12309.
  • 7- Sarıgül F, Doluca O, Akhan S, Sayan M. Investigation of compatibility of severe acute respiratory syndrome coronavirus 2 reverse transcriptase-PCR kits containing different gene targets during coronavirus disease 2019 pandemic. Future Virol. 2020;15(8):515-524. doi: 10.2217/fvl-2020-0169.
  • 8- Moniuszko-Malinowska A, Czupryna P, Boczkowska-Radziwon B, Wasiluk T, Borawski K, Dunaj J, et al. A 63-Year-Old Woman with SARS-CoV-2 Infection, Who Developed Severe COVID-19 Pneumonia and Was Supported with Convalescent Plasma Therapy. Am J Case Rep. 2020;21:e927662. Published 2020 Sep 29. doi:10.12659/AJCR.927662.
  • 9- Isbister GK, Page CB. Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice. Br J Clin Pharmacol. 2013;76(1):48-57. doi:10.1111/bcp.12040.212.
  • 10- Trinkley KE, Page RL, Lien H, Amanouye K, Tisdale JE. QT interval prolongation and the risk of torsades de pointes: essentials for clinicians. Curr Med Res Opin. 2013;29(12):1719-1726. doi:10.1185/03007995.2013.840568.
  • 11- Chen CY, Wang FL, Lin CC. Chronic HCQ use associated with QT prolongation and refractory ventricular arrhythmia. Clin Toxicol. 2006;44(2):173-175. doi:10.1080/15563650500514558.
  • 12- Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LCP, Veiga VC, Avezum A, et al; Coalition Covid-19 Brazil I Investigators. HCQ with or without Azithromycin in Mild-to-Moderate Covid-19. N Engl J Med. 2020;383(21):2041-2052. doi:10.1056/NEJMoa2019014.
  • 13- South AM, Diz DI, Chappell MC. COVID-19, ACE2, and the cardiovascular consequences. Am J Physiol Heart Circ Physiol. 2020;318(5):H1084-H1090. doi:10.1152/ajpheart.00217.2020.
  • 14- Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020;38(7):1504-1507. doi:10.1016/j.ajem.2020.04.048.
  • 15- Chico RM, Chandramohan D. Azithromycin plus chloroquine: combination therapy for protection against malaria and sexually transmitted infections in pregnancy. Expert Opin Drug Metab Toxicol. 2011;7(9):1153-1167. doi:10.1517/17425255.2011.598506.
  • 16- Hancox JC, Hasnain M, Vieweg WV, Crouse EL, Baranchuk A. Azithromycin, cardiovascular risks, QTc interval prolongation, torsade de pointes, and regulatory issues: A narrative review based on the study of case reports. Ther Adv Infect Dis. 2013;1(5):155-65. doi:10.1177/2049936113501816.
  • 17- Giudicessi JR, Roden DM, Wilde AAM, Ackerman MJ. Genetic susceptibility for COVID-19-associated sudden cardiac death in African Americans. Heart Rhythm. 2020;17(9):1487-1492. doi:10.1016/j.hrthm.2020.04.045.
  • 18- El-Sherif N, Turitto G. Electrolyte disorders and arrhythmogenesis. Cardiol J. 2011;18(3):233-245.
  • 19- Tisdale JE. Drug-induced QT interval prolongation and torsades de pointes: Role of the pharmacist in risk assessment, prevention and management. Can Pharm J 2016;149(3):139-152. doi:10.1177/1715163516641136.
  • 20- Lane JCE, Weaver J, Kostka K, Duarte-Salles T, Abrahao MTF, Alghoul H, et al; OHDSI-COVID-19 consortium. Risk of HCQ alone and in combination with azithromycin in the treatment of rheumatoid arthritis: a multinational, retrospective study. Lancet Rheumatol. 2020;2(11):e698-e711. doi:10.1016/S2665-9913(20)30276-9.
  • 21- Lu HR, Yan GX, Gallacher DJ. A new biomarker--index of cardiac electrophysiological balance (iCEB)--plays an important role in drug-induced cardiac arrhythmias: beyond QT-prolongation and Torsades de Pointes (TdPs). J Pharmacol Toxicol Methods. 2013;68(2):250-259. doi:10.1016/j.vascn.2013.01.003.

Relationship between index of cardio-electrophysiological balance and hydroxychloroquine in patients with COVID-19

Year 2022, Volume: 39 Issue: 2, 472 - 476, 18.03.2022

Abstract

Background: Hydroxychloroquine (HCQ) treatment is frequently prescribed for coronavirus disease 2019 (COVID-19). Electrocardiographic (ECG) monitorization is recommended because HCQ causes QT interval prolongation. The index of cardioelectrophysiological balance (iCEB), calculated as the ratio of QT interval / QRS duration. In recent years, iCEB has been described as an important marker for dysrhthmias. Decreased or increased iCEB is related with lethal ventricular arrhythmias.
Aim of the study: In our research, we purposed to investigate the relationship between iCEB and HCQ in patients with COVID-19.
Methods: 200 patients (males, 84 ; females, 116 ; 60.4 ± 13.8 years) with PCR positive and chest tomography findings compatible with COVID-19 pneumonia were registered in the research. Demographic, clinical, and laboratory data for all patients were collected. ECG was recorded from all patients on admission to COVID-19 clinic, in oral treatment with HCQ (200 mg, twice daily) for at least 5 days. iCEB (QT/QRS) was calculated from the 12-lead electrocardiogram.
Results: The mean age of the patients was 60.4 ± 13.8 years. Compared to admission ECG, ECG on day 5 showed significant increases in heart rate, QT interval, corrected QT (QTc) interval, and iCEB.
Conclusions: Our results suggested that iCEB is related with HCQ treatment in patients with COVID-19. Previous studies have show that high iCEB is related with torsade de Pointes (TdP), ventricular tachycardia.

References

  • 1- Cipriani A, Zorzi A, Ceccato D, Capone F, Parolin M, Donato F, et al. Arrhythmic profile and 24-hour QT interval variability in COVID-19 patients treated with HCQ and azithromycin. Int J Cardiol. 2020;316:280-284. doi:10.1016/j.ijcard.2020.05.036.
  • 2- Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. HCQ and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020;56(1):105949. doi:10.1016/j.ijantimicag.2020.105949.
  • 3- Jankelson L, Karam G, Becker ML, Chinitz LA, Tsai MC. QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or HCQ as used in COVID-19: A systematic review. Heart Rhythm. 2020;17(9):1472-1479. doi:10.1016/j.hrthm.2020.05.008.
  • 4- Ozturk O, Ozturk U, Nergiz S, Karahan MZ. The Relationship between Angiotensin-II Type 1 Receptor Gene Polymorphism and Repolarization Parameters after a First Anterior Acute Myocardial Infarction. Korean Circ J. 2016;46(6):791-797. doi:10.4070/kcj.2016.46.6.791.
  • 5- Ozturk U, Ozturk O. Relation between index of cardioelectrophysiological balance and stroke severity in patients with acute ischemic stroke. Niger J Clin Pract. 2020;23(6):768-774. doi:10.4103/njcp.njcp_505_19.
  • 6- Robyns T, Lu HR, Gallacher DJ, Garweg C, Ector J, Willems R, et al. Evaluation of Index of Cardio-Electrophysiological Balance (iCEB) as a New Biomarker for the Identification of Patients at Increased Arrhythmic Risk. Ann Noninvasive Electrocardiol. 2016;21(3):294-304. doi:10.1111/anec.12309.
  • 7- Sarıgül F, Doluca O, Akhan S, Sayan M. Investigation of compatibility of severe acute respiratory syndrome coronavirus 2 reverse transcriptase-PCR kits containing different gene targets during coronavirus disease 2019 pandemic. Future Virol. 2020;15(8):515-524. doi: 10.2217/fvl-2020-0169.
  • 8- Moniuszko-Malinowska A, Czupryna P, Boczkowska-Radziwon B, Wasiluk T, Borawski K, Dunaj J, et al. A 63-Year-Old Woman with SARS-CoV-2 Infection, Who Developed Severe COVID-19 Pneumonia and Was Supported with Convalescent Plasma Therapy. Am J Case Rep. 2020;21:e927662. Published 2020 Sep 29. doi:10.12659/AJCR.927662.
  • 9- Isbister GK, Page CB. Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice. Br J Clin Pharmacol. 2013;76(1):48-57. doi:10.1111/bcp.12040.212.
  • 10- Trinkley KE, Page RL, Lien H, Amanouye K, Tisdale JE. QT interval prolongation and the risk of torsades de pointes: essentials for clinicians. Curr Med Res Opin. 2013;29(12):1719-1726. doi:10.1185/03007995.2013.840568.
  • 11- Chen CY, Wang FL, Lin CC. Chronic HCQ use associated with QT prolongation and refractory ventricular arrhythmia. Clin Toxicol. 2006;44(2):173-175. doi:10.1080/15563650500514558.
  • 12- Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LCP, Veiga VC, Avezum A, et al; Coalition Covid-19 Brazil I Investigators. HCQ with or without Azithromycin in Mild-to-Moderate Covid-19. N Engl J Med. 2020;383(21):2041-2052. doi:10.1056/NEJMoa2019014.
  • 13- South AM, Diz DI, Chappell MC. COVID-19, ACE2, and the cardiovascular consequences. Am J Physiol Heart Circ Physiol. 2020;318(5):H1084-H1090. doi:10.1152/ajpheart.00217.2020.
  • 14- Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020;38(7):1504-1507. doi:10.1016/j.ajem.2020.04.048.
  • 15- Chico RM, Chandramohan D. Azithromycin plus chloroquine: combination therapy for protection against malaria and sexually transmitted infections in pregnancy. Expert Opin Drug Metab Toxicol. 2011;7(9):1153-1167. doi:10.1517/17425255.2011.598506.
  • 16- Hancox JC, Hasnain M, Vieweg WV, Crouse EL, Baranchuk A. Azithromycin, cardiovascular risks, QTc interval prolongation, torsade de pointes, and regulatory issues: A narrative review based on the study of case reports. Ther Adv Infect Dis. 2013;1(5):155-65. doi:10.1177/2049936113501816.
  • 17- Giudicessi JR, Roden DM, Wilde AAM, Ackerman MJ. Genetic susceptibility for COVID-19-associated sudden cardiac death in African Americans. Heart Rhythm. 2020;17(9):1487-1492. doi:10.1016/j.hrthm.2020.04.045.
  • 18- El-Sherif N, Turitto G. Electrolyte disorders and arrhythmogenesis. Cardiol J. 2011;18(3):233-245.
  • 19- Tisdale JE. Drug-induced QT interval prolongation and torsades de pointes: Role of the pharmacist in risk assessment, prevention and management. Can Pharm J 2016;149(3):139-152. doi:10.1177/1715163516641136.
  • 20- Lane JCE, Weaver J, Kostka K, Duarte-Salles T, Abrahao MTF, Alghoul H, et al; OHDSI-COVID-19 consortium. Risk of HCQ alone and in combination with azithromycin in the treatment of rheumatoid arthritis: a multinational, retrospective study. Lancet Rheumatol. 2020;2(11):e698-e711. doi:10.1016/S2665-9913(20)30276-9.
  • 21- Lu HR, Yan GX, Gallacher DJ. A new biomarker--index of cardiac electrophysiological balance (iCEB)--plays an important role in drug-induced cardiac arrhythmias: beyond QT-prolongation and Torsades de Pointes (TdPs). J Pharmacol Toxicol Methods. 2013;68(2):250-259. doi:10.1016/j.vascn.2013.01.003.
There are 21 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Şebnem Nergiz Öztürk 0000-0002-0166-9668

Önder Öztürk 0000-0003-4204-0599

Early Pub Date March 18, 2022
Publication Date March 18, 2022
Submission Date November 22, 2021
Acceptance Date January 21, 2022
Published in Issue Year 2022 Volume: 39 Issue: 2

Cite

APA Nergiz Öztürk, Ş., & Öztürk, Ö. (2022). Relationship between index of cardio-electrophysiological balance and hydroxychloroquine in patients with COVID-19. Journal of Experimental and Clinical Medicine, 39(2), 472-476.
AMA Nergiz Öztürk Ş, Öztürk Ö. Relationship between index of cardio-electrophysiological balance and hydroxychloroquine in patients with COVID-19. J. Exp. Clin. Med. March 2022;39(2):472-476.
Chicago Nergiz Öztürk, Şebnem, and Önder Öztürk. “Relationship Between Index of Cardio-Electrophysiological Balance and Hydroxychloroquine in Patients With COVID-19”. Journal of Experimental and Clinical Medicine 39, no. 2 (March 2022): 472-76.
EndNote Nergiz Öztürk Ş, Öztürk Ö (March 1, 2022) Relationship between index of cardio-electrophysiological balance and hydroxychloroquine in patients with COVID-19. Journal of Experimental and Clinical Medicine 39 2 472–476.
IEEE Ş. Nergiz Öztürk and Ö. Öztürk, “Relationship between index of cardio-electrophysiological balance and hydroxychloroquine in patients with COVID-19”, J. Exp. Clin. Med., vol. 39, no. 2, pp. 472–476, 2022.
ISNAD Nergiz Öztürk, Şebnem - Öztürk, Önder. “Relationship Between Index of Cardio-Electrophysiological Balance and Hydroxychloroquine in Patients With COVID-19”. Journal of Experimental and Clinical Medicine 39/2 (March 2022), 472-476.
JAMA Nergiz Öztürk Ş, Öztürk Ö. Relationship between index of cardio-electrophysiological balance and hydroxychloroquine in patients with COVID-19. J. Exp. Clin. Med. 2022;39:472–476.
MLA Nergiz Öztürk, Şebnem and Önder Öztürk. “Relationship Between Index of Cardio-Electrophysiological Balance and Hydroxychloroquine in Patients With COVID-19”. Journal of Experimental and Clinical Medicine, vol. 39, no. 2, 2022, pp. 472-6.
Vancouver Nergiz Öztürk Ş, Öztürk Ö. Relationship between index of cardio-electrophysiological balance and hydroxychloroquine in patients with COVID-19. J. Exp. Clin. Med. 2022;39(2):472-6.