Research Article
Year 2021,
, 1 - 7, 31.03.2021
Abstract
References
- Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020;395(10224):565‐574. doi:10.1016/S0140-6736(20)30251-8.
- WHO Novel Coronavirus (2019-nCoV) Situation Report - 1 21 January 2020. Available from https://www.who.int/docs/default-source/coronaviruse/situationreports/20200121-sitrep-1-2019 ncov.pdf?sfvrsn=20a99c10_4. (Accessed 28 Feb. 2020).
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- World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard, Data last updated: 2020/11/14, 3:32pm CET. (Accessed 18 Jan. 2021)
- Ahmet Aktaş, Burak Tüzün, Rukiye Aslan, Koray Sayin & Hilmi Ataseven (2020) New anti-viral drugs for the treatment of COVID-19 instead of favipiravir, Journal of Biomolecular Structure and Dynamics, DOI: 10.1080/07391102.2020.1806112
- Liu J, Cao R, Xu M, Wang X, Zhang H, Hu H, et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov. 2020;6(16). doi:10.1038/s41421-020-0156-0
- Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, et al. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis. 2020;71(15):732-739. doi:10.1093/cid/ciaa237
- Aktas, A., Tuzun, B., Taskin, A. H., Sayin, K., & Ataseven, H. (2020). How do arbidol and its analogs inhibit the SARS-CoV-2?. Bratislavske lekarske listy, 121(10), 705-711.
- Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020;14(1):72‐73. doi:10.5582/bst.2020.01047
- Madrid PB, Panchal RG, Warren TK, Shurtleff AC, Endsley AN, Green CE, et al. Evaluation of Ebola Virus Inhibitors for Drug Repurposing. ACS Infect Dis. 2015;1(7):317‐326. doi:10.1021/acsinfecdis.5b00030
- Retallack H, Di Lullo E, Arias C, Knopp KA, Laurie MT, Sandoval-Espinosa C, et al. Zika virus cell tropism in the developing human brain and inhibition by azithromycin. Proc Natl Acad Sci U S A. 2016;113(50):14408‐14413. doi:10.1073/pnas.1618029113
- Trac MH, McArthur E, Jandoc R, Dixon SN, Nash DM, Hackam DG, et al. Macrolide antibiotics and the risk of ventricular arrhythmia in older adults. CMAJ. 2016;188(7):E120‐E129. doi:10.1503/cmaj.150901
- Choi Y, Lim HS, Chung D, Choi JG, Yoon D. Risk evaluation of zzithromycin-induced QT prolongation in real-world practice. Biomed Res Int. 2018;2018:1574806. doi:10.1155/2018/1574806
- Frommeyer G, Fischer C, Ellermann C, Dechering DG, Kochhäuser S, Lange PS, et al. Additive proarrhythmic effect of combined treatment with QT-prolonging agents. Cardiovasc Toxicol. 2018;18(1):84‐90. doi:10.1007/s12012-017-9416-0
- Bakhshaliyev N, Uluganyan M, Enhos A, Karacop E, Ozdemir R. The effect of 5-day course of hydroxychloroquine and azithromycin combination on QT interval in non-ICU COVID19(+) patients. J Electrocardiol. 2020;62:59-64. doi:10.1016/j.jelectrocard.2020.08.008
- 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
- 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
- Wang X, Zhang L, Gao C, Zhu J, Yang X. Tpeak-Tend/QT interval predicts ST-segment resolution and major adverse cardiac events in acute ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention. Medicine (Baltimore). 2018 Oct;97(43):e12943. doi: 10.1097/MD.0000000000012943. PMID: 30412109; PMCID: PMC6221564.
- Ardahanli, I., & Celik, M. Comparison of Tp-e interval, QTc interval and Tp-e/QTc ratios between non-diabetic and prediabetic population. Ann Med Res 2020;27(12):3117-22. DOI: 10.5455/annalsmedres.2020.09.949
- Nafakhi H, Al-Mosawi AA, Alareedh M, Al-Nafakh HA. Index of cardiac electrophysiological balance and transmural dispersion of the repolarization index relationships with pericardial fat volume and coronary calcification. Biomark Med. 2018;12(4):321‐328. doi:10.2217/bmm-2017-0187
- Özdemir L, Sökmen E. Effect of habitual cigarette smoking on the index of cardiac electrophysiological balance in apparently healthy individuals. J Electrocardiol. 2020;59:41‐44. doi:10.1016/j.jelectrocard.2020.01.003
- Hemmeryckx B, Feng Y, Frederix L, Lox M, Trenson S, Vreeken R, et al. Evaluation of cardiac arrhythmic risks using a rabbit model of left ventricular systolic dysfunction. Eur J Pharmacol. 2018;832:145‐155. doi:10.1016/j.ejphar.2018.05.026
- 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 hydroxychloroquine and azithromycin. Int J Cardiol. 2020;316:280-284 doi:10.1016/j.ijcard.2020.05.036
- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. clinical characteristics of 138 hospitalized patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061‐1069. doi:10.1001/jama.2020.1585
A new index in the follow-up of arrhythmia of Coronavirus Disease-2019 (COVID-19) patients receiving Hydroxychloroquine and Azithromycin therapy; index of cardiac electrophysiological balance
Abstract
Objective: Index of cardiac electrophysiological balance (iCEB) is a relatively new electrocardiographic (ECG) parameter that shows the balance between ventricular depolarization and repolarization, thus providing more information than other conventional ECG parameters such as QT and corrected QT (cQT) intervals. This study aimed to evaluate the condition of iCEB with the treatment of hydroxychloroquine and azithromycin used in COVID-19 patients.
Method: The study was designed as cross-sectional and descriptive. Sixty three (52 male, 28.4 ± 10.7 years) COVID-19 patients with mild symptoms who received hydroxychloroquine and azithromycin treatment between 30 March and 30 June 2020 were included in the study. iCEB and corrected iCEB (iCEBc) values were calculated by dividing the respective QT and cQT intervals by the QRS duration.
Results: In the study group, the mean PR, QRS, QT and cQT intervals were similar between groups. While heart rate was significantly higher before treatment, iCEB and iCEBc increased significantly after treatment.
Conclusions: Our study did not observe a significant difference in QT and cQT intervals with hydroxychloroquine and azithromycin treatment in COVID-19. Still, there was a significant increase in the iCEB and iCEBc. We believe that the cardiac electrophysiological balance index can be used to monitor arrhythmias in patients undergoing short-term treatment at COVID -19.
References
- Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020;395(10224):565‐574. doi:10.1016/S0140-6736(20)30251-8.
- WHO Novel Coronavirus (2019-nCoV) Situation Report - 1 21 January 2020. Available from https://www.who.int/docs/default-source/coronaviruse/situationreports/20200121-sitrep-1-2019 ncov.pdf?sfvrsn=20a99c10_4. (Accessed 28 Feb. 2020).
- World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March. Available from URL: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020. (Accessed March 2020).
- World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard, Data last updated: 2020/11/14, 3:32pm CET. (Accessed 18 Jan. 2021)
- Ahmet Aktaş, Burak Tüzün, Rukiye Aslan, Koray Sayin & Hilmi Ataseven (2020) New anti-viral drugs for the treatment of COVID-19 instead of favipiravir, Journal of Biomolecular Structure and Dynamics, DOI: 10.1080/07391102.2020.1806112
- Liu J, Cao R, Xu M, Wang X, Zhang H, Hu H, et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov. 2020;6(16). doi:10.1038/s41421-020-0156-0
- Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, et al. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis. 2020;71(15):732-739. doi:10.1093/cid/ciaa237
- Aktas, A., Tuzun, B., Taskin, A. H., Sayin, K., & Ataseven, H. (2020). How do arbidol and its analogs inhibit the SARS-CoV-2?. Bratislavske lekarske listy, 121(10), 705-711.
- Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020;14(1):72‐73. doi:10.5582/bst.2020.01047
- Madrid PB, Panchal RG, Warren TK, Shurtleff AC, Endsley AN, Green CE, et al. Evaluation of Ebola Virus Inhibitors for Drug Repurposing. ACS Infect Dis. 2015;1(7):317‐326. doi:10.1021/acsinfecdis.5b00030
- Retallack H, Di Lullo E, Arias C, Knopp KA, Laurie MT, Sandoval-Espinosa C, et al. Zika virus cell tropism in the developing human brain and inhibition by azithromycin. Proc Natl Acad Sci U S A. 2016;113(50):14408‐14413. doi:10.1073/pnas.1618029113
- Trac MH, McArthur E, Jandoc R, Dixon SN, Nash DM, Hackam DG, et al. Macrolide antibiotics and the risk of ventricular arrhythmia in older adults. CMAJ. 2016;188(7):E120‐E129. doi:10.1503/cmaj.150901
- Choi Y, Lim HS, Chung D, Choi JG, Yoon D. Risk evaluation of zzithromycin-induced QT prolongation in real-world practice. Biomed Res Int. 2018;2018:1574806. doi:10.1155/2018/1574806
- Frommeyer G, Fischer C, Ellermann C, Dechering DG, Kochhäuser S, Lange PS, et al. Additive proarrhythmic effect of combined treatment with QT-prolonging agents. Cardiovasc Toxicol. 2018;18(1):84‐90. doi:10.1007/s12012-017-9416-0
- Bakhshaliyev N, Uluganyan M, Enhos A, Karacop E, Ozdemir R. The effect of 5-day course of hydroxychloroquine and azithromycin combination on QT interval in non-ICU COVID19(+) patients. J Electrocardiol. 2020;62:59-64. doi:10.1016/j.jelectrocard.2020.08.008
- 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
- 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
- Wang X, Zhang L, Gao C, Zhu J, Yang X. Tpeak-Tend/QT interval predicts ST-segment resolution and major adverse cardiac events in acute ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention. Medicine (Baltimore). 2018 Oct;97(43):e12943. doi: 10.1097/MD.0000000000012943. PMID: 30412109; PMCID: PMC6221564.
- Ardahanli, I., & Celik, M. Comparison of Tp-e interval, QTc interval and Tp-e/QTc ratios between non-diabetic and prediabetic population. Ann Med Res 2020;27(12):3117-22. DOI: 10.5455/annalsmedres.2020.09.949
- Nafakhi H, Al-Mosawi AA, Alareedh M, Al-Nafakh HA. Index of cardiac electrophysiological balance and transmural dispersion of the repolarization index relationships with pericardial fat volume and coronary calcification. Biomark Med. 2018;12(4):321‐328. doi:10.2217/bmm-2017-0187
- Özdemir L, Sökmen E. Effect of habitual cigarette smoking on the index of cardiac electrophysiological balance in apparently healthy individuals. J Electrocardiol. 2020;59:41‐44. doi:10.1016/j.jelectrocard.2020.01.003
- Hemmeryckx B, Feng Y, Frederix L, Lox M, Trenson S, Vreeken R, et al. Evaluation of cardiac arrhythmic risks using a rabbit model of left ventricular systolic dysfunction. Eur J Pharmacol. 2018;832:145‐155. doi:10.1016/j.ejphar.2018.05.026
- 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 hydroxychloroquine and azithromycin. Int J Cardiol. 2020;316:280-284 doi:10.1016/j.ijcard.2020.05.036
- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. clinical characteristics of 138 hospitalized patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061‐1069. doi:10.1001/jama.2020.1585
There are 24 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Medical Science Research Articles |
| Authors | |
| Publication Date | March 31, 2021 |
| Acceptance Date | February 5, 2021 |
| Published in Issue | Year 2021 |