I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Lublin, Poland.
Department of Endocrinology, Medical University of Lublin, Lublin, Poland.
PLoS One. 2019 Oct 23;14(10):e0224020. doi: 10.1371/journal.pone.0224020. eCollection 2019.
Electroconvulsive therapy (ECT) is an effective treatment method used in psychiatry; however, its cardiac safety has not been clearly demonstrated. The aim of the study was evaluation of the ECT effects on the myocardium based on troponin T concentrations and the following ECG parameters: the spatial QRS-T angle (QRS-TA), QRS duration (QRSd) and the corrected QT interval (QTc).
In the study 44 patients (12 female and 32 male) were enrolled diagnosed with schizophrenia (n = 21) and major depressive disorders (n = 23), according to the DSM-IVR criteria. All cases were undergoing ECT procedures. The mean age of the patients was 36.9±16 years (range: 18-74). Resting ECG was recorded before performing ECG and 1 hour after. The spatial QRS-TA was reconstructed from 12-lead ECG using the inverse Dower method. Troponin T concentration was assessed before the procedure and 6 hours after ECT.
No significant changes to troponin T concentrations were observed during the ECT series. The pre-ECT value of the spatial QRS-TA was 41.1±18.9°. The follow-up examinations did not reveal any significant increase of this parameter (p = 0.09) in any of the consecutive measurements. There were no significant changes in the QTc interval duration or the QRS complex duration demonstrated before the third, fifth and last procedure in the cycle (p>0.05). No significant changes to troponin T concentrations were observed during the ECT series.
Our findings indicate a lack of negative ECT effects on the risk of adverse cardiovascular events measured by the spatial QRS-T angle and cardiac troponin T concentration.
电抽搐治疗（ECT）是一种在精神病学中使用的有效治疗方法，但它的心脏安全性尚未得到明确证实。本研究的目的是基于肌钙蛋白 T 浓度和以下心电图参数评估 ECT 对心肌的影响：空间 QRS-T 角（QRS-TA）、QRS 持续时间（QRSd）和校正 QT 间期（QTc）。
在这项研究中，纳入了 44 名患者（12 名女性和 32 名男性），他们被诊断为精神分裂症（n=21）和重度抑郁症（n=23），符合 DSM-IVR 标准。所有病例均接受 ECT 治疗。患者的平均年龄为 36.9±16 岁（范围：18-74 岁）。在进行心电图检查之前和之后 1 小时记录静息心电图。使用逆 Dower 法从 12 导联心电图重建空间 QRS-TA。在治疗前和 ECT 后 6 小时评估肌钙蛋白 T 浓度。
在 ECT 系列中，肌钙蛋白 T 浓度没有明显变化。空间 QRS-TA 的术前值为 41.1±18.9°。随访检查未发现该参数在任何连续测量中显著增加（p=0.09）。在第 3、5 和最后一次治疗的周期中，QTc 间期持续时间或 QRS 复合波持续时间均无显著变化（p>0.05）。在 ECT 系列中，肌钙蛋白 T 浓度没有明显变化。
我们的研究结果表明，空间 QRS-TA 和肌钙蛋白 T 浓度测量的不良心血管事件风险没有 ECT 的负面作用。
