Morfologické změny elektrického srdečního poleu pacientů trpících depresivní poruchou a léčenýchdosulepinem

Morphological Changesof Electric Heart Field in Patients Suffering from Depressive Disorder and Treated with Dosulepin.

The cardio-toxic effects of therapeutic plasma levels of TCA (150 – 200 ng/ml in serum) are notquite so evident. New information about it bring the device of Cardiag 112.2, which can measuresimultaneously the ECG (electrocardiography), VCG (vectorcardiography) and BSPM (method ofbody surface potential mapping). With this device we made 2 studies.In the fi rst one, we tried to prove if in depressive patients in remission, treated with prophylacticdoses of dosulepine, are some statistically signifi cant changes in ECG parameters in dependence withdosulepine plasma levels. 4 electrocardiological parameters were proven to correlate signifi cantlywith dosulepine plasma levels: QRS axis deviation in frontal plane (by the method of VCG) (p < 0,01),the maximal positive value of the isointegral map during the fi rst 40 ms of the QRS complex, the socalled DIAM40max (by the method of BSPM) (p < 0,05) and QRS-STT vectors plane angles in transversaland in left sagittal planes (by the method of VCG) (p < 0,05).In the second one, we measured the dispersion of QT interval in depressive patients treated withdosulepine (by the method of BSPM) and than we correlated the QTd with dosulepine plasma levels.It was suggested as was by many authors, that dispersion of the QT interval (QTd) is a non specifi csign of a changed course of repolarization, which refl ects the cardiotoxic side effects of dosulepinand that it could be used also as a simple marker for the elevated plasma level of dosulepin on themyocardium at therapeutic or prophylactic plasma levels.The antidepressant of dosulepine is potentially dangerous in inducing of the cardiac arrhytmias indepressive patients without cardiac diseases, and this cardiovascular risk is in the correlation withdosulepine plasma levels.

Key words:
dosulepine, cardiotoxicity, body potential surface mapping, plasma levels.