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Nils Henninger - One of the best experts on this subject based on the ideXlab platform.
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dorsal vagal nucleus involvement relates to qtc Prolongation after acute medullary infarction
Acta Neurologica Scandinavica, 2021Co-Authors: Yuyao Sun, Kiandokht Keyhanian, Shadi Yaghi, Nils HenningerAbstract:Background Infarction of the medulla has been associated with Prolongation of the QTc, severe arrhythmia, and sudden cardiac death, yet the precise anatomical substrate remains uncertain. Aims We sought to determine the possible anatomical structures relating to QTc-Prolongation in patients with acute medullary infarction. Methods We included 12 subjects with acute ischemic medullary infarction on brain MRI, who presented within 4.5 h from the last known well time, with a 90-day follow-up. For an unbiased lesion analysis, medullary infarcts were manually outlined on diffusion weighted MRI and co-registered with an anatomical atlas. Results Nine out of 12 had QTc-Prolongation. Qualitative and semi-quantitative comparisons were made between infarct location and QTc-Prolongation. Among patients with QTc-Prolongation, the greatest degree of congruence of the infarct location was over the dorsal vagal nucleus (DVN, 8 out of 9). There was a significant correlation between the number of sections showing infarction of the DVN and presence of QTc-Prolongation (r = .582, p = .047). Among patients without QTc-Prolongation, the maximum lesion overlap included the medial aspect of the gigantocelluar reticular nucleus of the reticular formation. Conclusion We found that the DVN is a key anatomical substrate related to QTc-Prolongation. Further studies with more patients and high-resolution, volumetric MRI are needed to confirm our findings.
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abstract p130 qtc Prolongation in acute medullary infarction maps to the dorsal vagal nucleus
Stroke, 2021Co-Authors: Yuyao Sun, Kiandokht Keyhanian, Nils HenningerAbstract:Objective: To determine the spatial relationship between acute medullary infarction and QTc Prolongation. Background: Ischemic stroke has been associated with QTc-Prolongation which increases the r...
Yuyao Sun - One of the best experts on this subject based on the ideXlab platform.
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dorsal vagal nucleus involvement relates to qtc Prolongation after acute medullary infarction
Acta Neurologica Scandinavica, 2021Co-Authors: Yuyao Sun, Kiandokht Keyhanian, Shadi Yaghi, Nils HenningerAbstract:Background Infarction of the medulla has been associated with Prolongation of the QTc, severe arrhythmia, and sudden cardiac death, yet the precise anatomical substrate remains uncertain. Aims We sought to determine the possible anatomical structures relating to QTc-Prolongation in patients with acute medullary infarction. Methods We included 12 subjects with acute ischemic medullary infarction on brain MRI, who presented within 4.5 h from the last known well time, with a 90-day follow-up. For an unbiased lesion analysis, medullary infarcts were manually outlined on diffusion weighted MRI and co-registered with an anatomical atlas. Results Nine out of 12 had QTc-Prolongation. Qualitative and semi-quantitative comparisons were made between infarct location and QTc-Prolongation. Among patients with QTc-Prolongation, the greatest degree of congruence of the infarct location was over the dorsal vagal nucleus (DVN, 8 out of 9). There was a significant correlation between the number of sections showing infarction of the DVN and presence of QTc-Prolongation (r = .582, p = .047). Among patients without QTc-Prolongation, the maximum lesion overlap included the medial aspect of the gigantocelluar reticular nucleus of the reticular formation. Conclusion We found that the DVN is a key anatomical substrate related to QTc-Prolongation. Further studies with more patients and high-resolution, volumetric MRI are needed to confirm our findings.
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abstract p130 qtc Prolongation in acute medullary infarction maps to the dorsal vagal nucleus
Stroke, 2021Co-Authors: Yuyao Sun, Kiandokht Keyhanian, Nils HenningerAbstract:Objective: To determine the spatial relationship between acute medullary infarction and QTc Prolongation. Background: Ischemic stroke has been associated with QTc-Prolongation which increases the r...
Kiandokht Keyhanian - One of the best experts on this subject based on the ideXlab platform.
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dorsal vagal nucleus involvement relates to qtc Prolongation after acute medullary infarction
Acta Neurologica Scandinavica, 2021Co-Authors: Yuyao Sun, Kiandokht Keyhanian, Shadi Yaghi, Nils HenningerAbstract:Background Infarction of the medulla has been associated with Prolongation of the QTc, severe arrhythmia, and sudden cardiac death, yet the precise anatomical substrate remains uncertain. Aims We sought to determine the possible anatomical structures relating to QTc-Prolongation in patients with acute medullary infarction. Methods We included 12 subjects with acute ischemic medullary infarction on brain MRI, who presented within 4.5 h from the last known well time, with a 90-day follow-up. For an unbiased lesion analysis, medullary infarcts were manually outlined on diffusion weighted MRI and co-registered with an anatomical atlas. Results Nine out of 12 had QTc-Prolongation. Qualitative and semi-quantitative comparisons were made between infarct location and QTc-Prolongation. Among patients with QTc-Prolongation, the greatest degree of congruence of the infarct location was over the dorsal vagal nucleus (DVN, 8 out of 9). There was a significant correlation between the number of sections showing infarction of the DVN and presence of QTc-Prolongation (r = .582, p = .047). Among patients without QTc-Prolongation, the maximum lesion overlap included the medial aspect of the gigantocelluar reticular nucleus of the reticular formation. Conclusion We found that the DVN is a key anatomical substrate related to QTc-Prolongation. Further studies with more patients and high-resolution, volumetric MRI are needed to confirm our findings.
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abstract p130 qtc Prolongation in acute medullary infarction maps to the dorsal vagal nucleus
Stroke, 2021Co-Authors: Yuyao Sun, Kiandokht Keyhanian, Nils HenningerAbstract:Objective: To determine the spatial relationship between acute medullary infarction and QTc Prolongation. Background: Ischemic stroke has been associated with QTc-Prolongation which increases the r...
Jelena Kornej - One of the best experts on this subject based on the ideXlab platform.
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association between echocardiographic parameters and biomarkers in probands with atrial fibrillation and different pr interval lengths insight from the epidemiologic life adult study
PLOS ONE, 2019Co-Authors: Jelena Kornej, Samira Zeynalova, Joachim Thiery, Ralph Burkhardt, Ronny Baber, Christoph Engel, Andreas Hagendorff, Markus Loeffler, Daniela HusserAbstract:Background PR interval Prolongation is associated with increased risk for atrial fibrillation (AF). Different biomarkers are used to predict AF incidence and its outcomes. The aim of this study was to investigate the association between echocardiographic parameters and blood biomarkers in PR interval groups and AF. Methods The LIFE-Adult-Study is a population-based cohort study of randomly selected participants from Leipzig, Germany. In this cross-sectional analysis, individuals ≥40 years with available echocardiographic (LA diameter, EF) and laboratory data (creatinine, Troponin, NT-proBNP) were included. Results The study population comprised 1.429 individuals (median age 56 (IQR 48–66) years, 40% males) with complete ECG, echocardiographic and laboratory data. There were 48 (3.4%) individuals with AF, 177 (12.4%) with short, 138 (9.7%) with prolonged and 1.066 (74.5%) with normal PR interval. Individuals with PR interval Prolongation had larger LA diameter, higher Troponin and NT-proBNP levels than individuals with normal PR interval, but lower than AF group (p<0.001). In contrast, eGFR was significantly higher in the group with PR interval Prolongation than in AF, but lower than in individuals with normal PR interval (p<0.001). In the multivariate analysis, PR interval Prolongation and AF shared similar characteristics, the only parameter different between both groups was NT-proBNP. Conclusions Individuals with PR interval Prolongation and AF showed similarities in echocardiographic parameters, renal function and blood biomarker levels. Longitudinal studies are necessary to prove whether the PR interval Prolongation may be considered as preliminary stage for AF.
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association between pr interval Prolongation and electro anatomical substrate in patients with atrial fibrillation
PLOS ONE, 2018Co-Authors: Katja Schumacher, Petra Buttner, Nikolaos Dagres, Philipp Sommer, Borislav Dinov, Gerhard Hindricks, Andreas Bollmann, Jelena KornejAbstract:Background Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical routine. Left atrial (LA) electro-anatomical remodelling in AF patients indicates disease progression and is associated with poor therapeutic success. PR interval Prolongation is associated with an increased risk for AF, however, the association between LA remodelling measured as low voltage areas (LVA) during catheter ablation and PR interval is unknown. The aim of this study was to investigate the association between PR interval Prolongation and LVA in AF patients. Methods We studied 103 patients (62±12 years, 59% males, 34% persistent AF) undergoing first AF catheter ablation and presenting with sinus rhythm. PR interval Prolongation was defined as PR >200ms and analysed in resting ECG before intervention. LVA were determined using high-density maps and defined as <0.5 mV. Results There were 24 patients (23%) with PR interval Prolongation and 18 patients (17%) with LVA. There were significant correlations between PR Prolongation with LVA, CHA2DS2-VASc score and eGFR (r2 = 0.230, 0.216, and 0.307, all p<0.05). PR interval Prolongation (OR 3.450, p = 0.024), persistent AF (OR 5.391, p = 0.002), and LA size (OR 1.117, p = 0.018) were significant predictors for LVA, while age (OR 1.072, p = 0.005), LVA (OR 3.450 p = 0.024) and eGFR (OR 0.962, p = 0.004) were associated with PR interval Prolongation. Conclusions Beside persistent AF and LA size, PR interval Prolongation might be useful for the prediction of electro-anatomical substrate in AF patients. Larger studies are needed to confirm these results.
Christian Funckbrentano - One of the best experts on this subject based on the ideXlab platform.
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relationship between hiv protease inhibitors and qtc interval duration in hiv infected patients a cross sectional study
British Journal of Clinical Pharmacology, 2009Co-Authors: Beny Charbit, Arnaud Rosier, Diane Bollens, Franck Boccara, Pierreyves Boelle, Afef Koubaa, Pierremarie Girard, Christian FunckbrentanoAbstract:WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • The risks of torsade de pointes and QTc Prolongation in HIV patients have been reported. • Authors have shown that four protease inhibitors (PIs) blocked human ether-a-go-go-related gene (hERG), the current that underlies QTc Prolongation and drug-induced proarrhythmia, and have also reported cases of torsades and suggested that PIs were responsible for these adverse events. • This earlier paper has had a major impact on the perception of the arrhythmogenic risk associated with PIs, and regulatory agencies in Europe and the USA have modified the labelling of PIs accordingly. WHAT THIS STUDY ADDS • The present study provides alternative explanations for QTc Prolongation in a cohort of HIV patients and reports ECG abnormalities found in such patients. • It does not confirm that PIs play a significant role in QTc interval Prolongation in HIV patients. • In contrast, it shows that QTc Prolongation is related to common causes and to the duration of HIV infection rather than to anti-HIV treatments. AIMS QTc interval Prolongation and torsades de pointes have been reported in HIV-infected patients. Protease inhibitors (PIs) are suspected to contribute to this adverse reaction. However, many factors can prolong QTc interval. We examined factors influencing QTc duration in HIV-infected patients. METHODS Unselected HIV-infected patients (n = 978) were enrolled in this prospective, single-centre cross-sectional study. Variables related to infection and treatments were collected. A digital electrocardiographic record was recorded in each patient and QT interval duration was measured and corrected using both Bazett's (QTcB) and Fridericia's (QTcF) formula. Results were analysed with a multivariable linear model. RESULTS After excluding arrhythmias and complete bundle branch blocks, QT interval was measured in 956 patients. The mean (SD) QTcB was 418 ms (23) and QTcF was 405 ms (20). QTc was found prolonged (>450 ms in women and >440 ms in men) in 129 [13.5%; 95% confidence interval (CI) 11.5, 15.8] and 38 (4%; 95% CI 2.9, 5.4) patients using Bazett and Fridericia corrections, respectively. On multivariable analysis, incomplete bundle branch block, ventricular hypertrophy, signs of ischaemic cardiopathy, female gender, White ethnic origin and age were significantly associated with QTc Prolongation. The only HIV variable independently associated with QTc Prolongation was the duration of infection (P = 0.023). After adjustment, anti-HIV treatment, in particular PI (P = 0.99), was not associated with QTc Prolongation. CONCLUSIONS Although PIs block in vitro hERG current, they are not independently associated with QTc interval Prolongation. Prolonged QTc interval in HIV-infected patients is primarily associated with factors commonly known to prolong QT and with the duration of HIV infection.
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droperidol and ondansetron induced qt interval Prolongation a clinical drug interaction study
Anesthesiology, 2008Co-Authors: Beny Charbit, Jeanlouis Demolis, Jeanclaude Alvarez, Eric Dasque, Emuri Abe, Christian FunckbrentanoAbstract:Background Droperidol and ondansetron have previously been found to prolong the QT interval in the treatment of postoperative nausea and vomiting. However, this adverse effect has never been confirmed and compared with both drugs under controlled conditions. The objective was to study the effects of droperidol and ondansetron alone or in combination on QT interval duration in healthy subjects. Methods Sixteen healthy volunteers, eight males and eight females, were enrolled in this prospective, double-blind, randomized, placebo-controlled study. Subjects received 1 mg droperidol, 4 mg ondansetron, 1 mg droperidol plus 4 mg ondansetron, or a placebo, intravenously in a crossover design. Fridericia-corrected QT interval (QTcF) and plasma concentrations were measured repeatedly during 10 h at each study period. The primary endpoint was the maximal placebo time-matched and baseline-subtracted QTcF Prolongation (DeltaDeltaQTcF). Results Compared with placebo, both droperidol and ondansetron significantly prolonged the QTcF interval. DeltaDeltaQTcF Prolongation was 25 +/- 8 ms after droperidol, significantly greater than the 17 +/- 10-ms Prolongation with ondansetron (P = 0.014). The combination of droperidol and ondansetron significantly increased the mean maximal DeltaDeltaQTcF by 28 +/- 10 ms. The combination induced greater QTcF Prolongation compared with ondansetron alone (P = 0.001), but not with droperidol alone (P = 0.33). There was no significant pharmacokinetic interaction between droperidol and ondansetron. Conclusions Under controlled conditions, both droperidol and ondansetron either alone or in combination induced significant marked QTc interval Prolongation. However, the combination of both drugs did not significantly increase QTc Prolongation compared with that induced by droperidol alone.
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effects of a single oral dose of sparfloxacin on ventricular repolarization in healthy volunteers
British Journal of Clinical Pharmacology, 2003Co-Authors: Jeanlouis Demolis, A Charransol, Christian Funckbrentano, Patrice JaillonAbstract:1Sparfloxacin, a new fluoroquinolone, slightly increases the duration of the QT interval. Reverse rate-dependence of QT interval Prolongation has been shown for many agents that are known to prolong QT interval duration, and QT Prolongation at slow heart rates may be a risk factor for torsades de pointes. 2A double-blind, randomized, placebo controlled, crossover study was performed in 15 healthy volunteers to determine the effects of single oral doses of sparfloxacin (200 and 400 mg) on the QT interval at various heart rates. 312-lead ECGs were recorded at rest and during exercise tests 5 h after sparfloxacin or placebo administration. QT intervals were calculated at predetermined RR intervals (1000, 800, 700, 600, 500 and 400 ms) after individual QT-RR curve fitting. 4Sparfloxacin at both doses induced Prolongation of the QT interval which was around 4% greater than placebo. No significant reverse rate-dependence of QT interval Prolongation was observed. 5Oral administration of sparfloxacin appears unlikely to be associated with marked QT interval Prolongation.
