Abstract：
Cardiovascular disease is a major global burden and a leading cause of premature death among patients with severe mental illness. Over time, research and clinical practice have paid increased attention to the impact of psychiatric medications on cardiac repolarization. In a resource-limited setting, it is common for psychotropic medications to be initiated and maintained in an outpatient setting without baseline or follow up ECG. This study evaluated the determinants and predictors of QT abnormalities among patient taking psychotropic drugs. We conducted a cross-sectional study in a population of 150 psychiatric patients on psychotropics and 75 controls. We studied the effects of various psychotropic drugs on QT dispersion (QTd) and corrected QT interval (QTc) as well as correlation with the types and dosages of psychotropic drugs used. All the subjects had detailed clinical examination and resting electrocardiogram (ECG) at 25 mm/sec done. QTc was determined using Bazett formula and QTd was determined by subtracting shortest from longest QT in 12-lead ECG. The prevalence of prolonged QTc and QTd as well as the mean QTc and QTd were significantly higher in patients than the control group. The mean QTc was significantly higher in patient on typical antipsychotics compared to those on atypical antipsychotics. Age, heart rate and antipsychotic dose in chlorpromazine equivalent were predictors of QTc with the heart rate being the most powerful predictor among them. Psychotropic drugs use is associated with QTc and QTd prolongation with age, heart rate and antipsychotic dose as predictors of QTc.
摘要：
心血管疾病是全球的主要负担，也是严重精神疾病患者过早死亡的主要原因。随着时间的推移,研究和临床实践越来越关注精神病药物对心脏复极的影响。在资源有限的环境中，精神药物治疗通常在门诊开始并维持,没有基线或随访ECG.这项研究评估了服用精神药物的患者QT异常的决定因素和预测因素。我们在150名精神病患者和75名对照人群中进行了横断面研究。我们研究了各种精神药物对QT离散度（QTd）和校正的QT间期（QTc）的影响，以及与所用精神药物的类型和剂量的相关性。所有受试者在25mm/sec下进行详细的临床检查和静息心电图(ECG)。使用Bazett公式确定QTc，并通过从12导联ECG中的最长QT中减去最短QT来确定QTd。患者QTc和QTd延长的患病率以及平均QTc和QTd明显高于对照组。与使用非典型抗精神病药的患者相比，使用典型抗精神病药的患者的平均QTc明显更高。年龄,心率和氯丙嗪当量的抗精神病药物剂量是QTc的预测因子，其中心率是最有效的预测因子。精神药物使用与QTc和QTd随年龄延长有关,心率和抗精神病药剂量作为QTc的预测因子。
