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抑郁、焦虑及抗抑郁药使用与T波振幅和QT间期的关联。

Association Between Depression, Anxiety, and Antidepressant Use With T-Wave Amplitude and QT-Interval.

作者信息

Hu Mandy X, Lamers Femke, Penninx Brenda W J H, de Geus Eco J C

机构信息

Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands.

Department of Biological Psychology, VU University, Amsterdam, Netherlands.

出版信息

Front Neurosci. 2018 Jun 5;12:375. doi: 10.3389/fnins.2018.00375. eCollection 2018.

Abstract

Cardiac repolarization may be affected by psychiatric disorders and/or antidepressant use, but evidence for this is inconclusive. This study examined the relationship between depressive and anxiety disorder and use of antidepressants with T-wave amplitude (TWA) and QT-interval. Data was obtained from the Netherlands Study of Depression and Anxiety ( = 1,383). Depression/anxiety was diagnosed with the DSM-IV based Composite International Diagnostic Interview. The use of tricyclic antidepressants (TCAs), selective serotonin and noradrenalin reuptake inhibitors (SNRIs), and selective serotonin reuptake inhibitors (SSRIs) was established. T-wave amplitude and QT-interval corrected for heart rate (QTc) were obtained from an ECG measured in a type II axis configuration. Compared to controls, persons with depression or anxiety disorders did not show a significantly different TWA ( = 0.58; Cohen's = 0.046) or QTc ( = 0.48; Cohen's = -0.057). In spite of known sympathomimetic effects, TCA use ( = 0.26; Cohen's = -0.162) and SNRI use ( = 0.70; Cohen's = -0.055) were not significantly associated with a lower TWA. TCA use ( = 0.12; Cohen's = 0.225) and SNRI use ( = 0.11; Cohen's = 0.227) were also not significantly associated with a prolonged QTc. We did not find evidence that either depressive/anxiety disorder or antidepressant use is associated with abnormalities in TWA or QTc. Earlier found sympathomimetic effects of TCAs and SNRIs are not evident in these measures of cardiac repolarization.

摘要

心脏复极可能会受到精神障碍和/或抗抑郁药使用的影响,但这方面的证据尚无定论。本研究探讨了抑郁和焦虑障碍以及抗抑郁药的使用与T波振幅(TWA)和QT间期之间的关系。数据取自荷兰抑郁与焦虑研究(n = 1383)。根据基于《精神疾病诊断与统计手册第四版》的复合国际诊断访谈来诊断抑郁/焦虑。确定了三环类抗抑郁药(TCA)、选择性5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRI)以及选择性5-羟色胺再摄取抑制剂(SSRI)的使用情况。T波振幅和经心率校正的QT间期(QTc)通过在II型轴配置下测量的心电图获得。与对照组相比,患有抑郁或焦虑障碍的人TWA(p = 0.58;科恩d = 0.046)或QTc(p = 0.48;科恩d = -0.057)没有显著差异。尽管已知有拟交感神经作用,但使用TCA(p = 0.26;科恩d = -0.162)和SNRI(p = 0.70;科恩d = -0.055)与较低的TWA没有显著关联。使用TCA(p = 0.12;科恩d = 0.225)和SNRI(p = 0.11;科恩d = 0.227)与QTc延长也没有显著关联。我们没有发现证据表明抑郁/焦虑障碍或抗抑郁药的使用与TWA或QTc异常有关。早期发现的TCA和SNRI的拟交感神经作用在这些心脏复极指标中并不明显。

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