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      Influence of Recurrent Electroconvulsive Therapy on Cardiac Function

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          Abstract

          Objective

          To investigate the effects of recurrent electroconvulsive therapy (ECT) on cardiac function as assessed by echocardiography.

          Subjects and Methods

          Twenty-three patients (11 males and 12 females) with different psychiatric disorders who were apparently free of any cardiovascular disorders and underwent ECT were enrolled in the study. Echocardiographic findings including diastolic mitral inflow and tissue Doppler features were recorded at baseline and at the end of the 7th and last ECT in all patients.

          Results

          The mean age of the patients was 37.95 ± 13.28 years (range 19-71). There was no significant difference in mitral E wave velocities and tissue Doppler E’ velocities between the baseline and after the 1st ECT (p = 0.161 and p = 0.083, respectively). The results were similar after the last ECT session (p = 0.463 and p = 0.310, respectively). However, there was a significant increase in transmitral A wave velocity after the 1st and 7th ECT session compared to the values at baseline (p = 0.008 and p = 0.017, respectively).

          Conclusion

          The mitral diastolic inflow A wave velocity increased 20 min after ECT, and this increase persisted after recurrent ECT sessions. This finding could be considered as an indicator of acutely increased sympathetic tone.

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          Most cited references11

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          Anesthesia for electroconvulsive therapy.

          Zhengnian Ding, Aaron P White (2002)
          Article 0 comments Cited 37 times – based on 0 reviews     Review now
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            Impact of body mass index on left ventricular diastolic dysfunction.

            Habib Cil, Ahmet Karabacak, Yusuf Aslantaş … (2012)
            The prevalence of obesity is increasing in the developed and developing world. It is an independent risk factor for heart failure. Left ventricular (LV) diastolic dysfunction has been demonstrated to be a strong predictor of heart failure. In the present study we aimed to assess the impact of body weight on LV diastolic function. The study was conducted on 2,228 participants (1,424 women, 804 men with a mean age of 49). Traditional and tissue Doppler echocardiographic examination were performed in all of the participants. The demographic and echocardiographic data were compared. Multivariate logistic regression analysis was used to assess the independent predictors of association of LV diastolic function. The study sample was divided into four groups: group 1 (body mass index [BMI] < 25.0 kg/m(2) ), group 2 (BMI 25.0-29.9 kg/m(2)), group 3 (BMI ≥ 30-39.9 kg/m(2)), and group 4 (BMI ≥ 40 kg/m(2)). Septal E was significantly lower in groups 2 and 3 compared to group 1 (P = 0.003). Septal A and septal A' were significantly higher whereas septal E' and lateral E' were significantly lower in the groups 2, 3, and 4 compared to the normal weight group (P < 0.001). Lateral A', deceleration time, and ejection time were significantly higher in obese when compared to the normal weight (P = 0.025, P < 0.001, and P = 0.009, respectively). The E/E' ratio was significantly higher in groups 2, 3, and 4 compared to the group 1 (P < 0.001). Logistic regression analysis revealed that age, BMI (OR = 1.060 [95% CI = 1.040 and 1.080]; P < 0.001), hypertension, and diabetes mellitus were independent predictors of LV diastolic dysfunction. BMI is an independent predictor of LV diastolic dysfunction along with age, hypertension, and diabetes mellitus. © 2012, Wiley Periodicals, Inc.
            Article 0 comments Cited 13 times – based on 0 reviews     Review now
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              Tissue Doppler imaging identifies asymptomatic normotensive diabetics with diastolic dysfunction and reduced exercise tolerance.

              Diana C F Monteiro, Mônica R. O. G. C. M. Silva, Monica P C Duarte … (2005)
              Early recognition of heart disease in diabetics is a highly desirable goal, and diastolic dysfunction, one of its earliest manifestations, can be readily assessed by tissue Doppler imaging. We tested in normotensive diabetics without signs of coronary artery disease whether tissue Doppler imaging would improve the diagnosis of diastolic dysfunction beyond classical criteria and identify patients already presenting impaired cardiac performance. We studied 79 patients (56 males, 55 type-2 diabetes mellitus) who underwent Doppler echocardiography, and exercise testing. Diastolic dysfunction was diagnosed either based on European Study Group on Diastolic Heart Failure guidelines or by tissue Doppler imaging provided that both of the following criteria were met: Em/Am ratio <1; and Em < 8.5 cm/sec. Tissue Doppler imaging identified diastolic dysfunction in 26.6% of diabetics, while classical criteria did so in 40.5% of the cases. The group identified by classical criteria did not differ significantly from patients without diastolic dysfunction, while in the group identified by Tissue Doppler imaging, significant differences were highlighted, including worse exercise tolerance and higher left ventricular mass index. Moreover, in multiple regression analysis, Em myocardial velocity and body mass index were the only variables independently related to exercise tolerance. Differently from classical criteria based on pulsed Doppler, Tissue Doppler imaging identifies a group of asymptomatic normotensive diabetics with diastolic dysfunction and reduced exercise tolerance. Confirmation of the prognostic importance of our findings could justify the use of Tissue Doppler imaging for diastolic function assessment in diabetics with otherwise healthy hearts.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med Princ Pract
                Journal ID (iso-abbrev): Med Princ Pract
                Journal ID (publisher-id): MPP
                Title: Medical Principles and Practice
                Publisher: S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch )
                ISSN (Print): 1011-7571
                ISSN (Electronic): 1423-0151
                Publication date (Print): May 2014
                Publication date (Electronic): 16 April 2014
                Publication date PMC-release: 16 April 2014
                Volume: 23
                Issue: 3
                Pages: 225-228
                Affiliations
                [1] aDepartment of Psychiatry, Gaziantep University, School of Medicine, Kilis, Turkey
                [2] bDepartment of Cardiology, Gaziantep University, School of Medicine, Kilis, Turkey
                [3] cDepartment of Anesthesiology, Gaziantep University, School of Medicine, Kilis, Turkey
                [4] dDepartment of Cardiology, 25 Aralik State Hospital, Gaziantep, Turkey
                [5] eDepartment of Department of Cardiology, Kilis State Hospital, Kilis, Turkey
                Author notes
                *Hayri Alici, MD, Department of Cardiology, 25 Aralik State Hospital, TR–27310 Gaziantep (Turkey), E-Mail mhayrialici@ 123456hotmail.com
                Article
                Publisher ID: mpp-0023-0225
                DOI: 10.1159/000361030
                PMC ID: 5586887
                PubMed ID: 24751485
                SO-VID: 6d6f800b-3391-4680-9e00-be772d9f1fc6
                Copyright © Copyright © 2014 by S. Karger AG, Basel
                License:

                This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.

                History
                Date received : 13 November 2013
                Date accepted : 3 March 2014
                Page count
                Tables: 1, References: 11, Pages: 4
                Categories
                Subject: Original Paper

                Keywords: echocardiography,diastolic function,electroconvulsive therapy
                Data availability:
                Keywords: echocardiography, diastolic function, electroconvulsive therapy

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