Статья
УДЛИНЕНИЕ ИНТЕРВАЛА QTC: РОЛЬ ПОЛИПРАГМАЗИИ, ЛЕКАРСТВЕННОЕ ВЗАИМОДЕЙСТВИЕ И РЕКОМЕНДАЦИИ ДЛЯ КЛИНИЧЕСКОЙ ПРАКТИКИ
Основные положения Приобретенный синдром удлиненного интервала QT – редкое заболевание, но частота его встречаемости растет при полипрагмазии. Резюме Приобретенный синдром удлиненного интервала QT является редким заболеванием. Однако частота встречаемости удлиненного интервала QTc увеличивается у пациентов с полипрагмазией. Риск как удлинения интервала QTc, так и тахикардии типа «пируэт» возрастает экспоненциально при одновременном применении нескольких препаратов, удлиняющих интервал QTc. В статье показаны механизмы, лежащие в основе заболевания, и способы снижения риска потенциально фатальных аритмий.
1. Castiglione A., Odening K. QT-Zeit – Was fange ich eigentlich damit an? [QT Interval and Its Prolongation - What Does It Mean?]. Dtsch Med Wochenschr. 2020;145(8):536-542. doi: 10.1055/a-0969-6312.
2. Uvelin A., Pejaković J., Mijatović V. Acquired prolongation of QT interval as a risk factor for torsade de pointes ventricular tachycardia: a narrative review for the anesthesiologist and intensivist. J Anesth. 2017;31(3):413-423. doi: 10.1007/s00540-017-2314-6.
3. Beach S.R., Celano C.M., Sugrue A.M., Adams C., Ackerman M.J., Noseworthy P.A., Huffman JC. QT Prolongation, Torsades de Pointes, and Psychotropic Medications: A 5-Year Update. Psychosomatics. 2018;59(2):105-122. doi: 10.1016/j.psym.2017.10.009.
4. Урясьев О.М., Жукова Л.А., Глотов С.И., Алексеева Е.А., Максимцева Е.А Удлинение и укорочение интервала QT-предикторы внезапной сердечной смерти. Земский врач. 2020;1:27-32.
5. Остроумова О.Д., Голобородова И.В. Влияние отдельных групп лекарственных препаратов на риск удлинения интервала QTс. Consilium Medicum. 2019; 21 (10): 95–106. doi: 10.26442/20751753.2019.10.190447
6. Marengoni A., Onder G. Guidelines, polypharmacy, and drug-drug interactions in patients with multimorbidity. BMJ. 2015;350:h1059. doi: 10.1136/bmj.h1059.
7. Marostica E., Van Ammel K., Teisman A., Boussery K., Van Bocxlaer J., De Ridder F., Gallacher D., Vermeulen A. Modelling of drug-induced QT-interval prolongation: estimation approaches and translational opportunities. J Pharmacokinet Pharmacodyn. 2015;42(6):659-79. doi: 10.1007/s10928-015-9434-0.
8. Khatib R., Sabir F.R.N., Omari C., Pepper C., Tayebjee M.H. Managing drug-induced QT prolongation in clinical practice. Postgrad Med J. 2021;97(1149):452-458. doi: 10.1136/postgradmedj-2020-138661.
9. Tan H., Yan X., Chen Y., Huang G., Luo L., Li W., Lan W., Chen C., Xi X. A real-world pharmacovigilance study of drug-induced QT interval prolongation: analysis of spontaneous reports submitted to FAERS. Front Cardiovasc Med. 2024;11:1363382. doi: 10.3389/fcvm.2024.1363382.
10. Priori S.G., Blomstrom-Lundqvist C., Mazzanti A., Blom N., Borggrefe M., Camm J., Elliott P.M., Fitzsimons D., et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 2015; 36: 2793-2867. doi: 10.1093/eurheartj/ehv316.
11. Al-Khatib S.M., Stevenson W.G., Ackerman M.J., Bryant W.J., Callans D.J., Curtis A.B., Deal B.J., Dickfeld T., et al. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2018; 72: e91-e220
12. Dahlberg P., Diamant U.B., Gilljam T., Rydberg A., Bergfeldt L. QT correction using Bazett's formula remains preferable in long QT syndrome type 1 and 2. Ann Noninvasive Electrocardiol. 2021;26(1):e12804. doi: 10.1111/anec.12804.
13. Yazdanpanah M.H., Naghizadeh M.M., Sayyadipoor S., Farjam M. The best QT correction formula in a non-hospitalized population: the Fasa PERSIAN cohort study. BMC Cardiovasc Disord. 2022;22(1):52. doi: 10.1186/s12872-022-02502-2.
14. Kallergis E.M., Goudis C.A., Simantirakis E.N., Kochiadakis G.E., Vardas P.E. Mechanisms, risk factors, and management of acquired long QT syndrome: a comprehensive review. Scientific World Journal 2012; 2012: 212178. doi: 10.1100/2012/212178.
15. Baracaldo-Santamaría D., Llinás-Caballero K., Corso-Ramirez J.M., Restrepo C.M., Dominguez-Dominguez C.A., Fonseca-Mendoza D.J., Calderon-Ospina C.A. Genetic and molecular aspects of drug-induced QT interval prolongation. Int J Mol Sci 2021; 22: 8090. doi: 10.3390/ijms22158090.
16. Welten S.J.G.C., van der Heijden A.A., Remmelzwaal S., Blom M.T., Nijpels G., Rutters F., Beulens J.W.J., Elders P.J.M.; ESCAPE-NET investigators. Prolongation of the QTc interval is associated with an increased risk of cardiovascular diseases: The Hoorn study. J Electrocardiol. 2023;80:133-138. doi: 10.1016/j.jelectrocard.2023.06.001.
17. Vandael E., Vandenberk B., Vandenberghe J., Willems R., Foulon V. Risk factors for QTc-prolongation: systematic review of the evidence. Int J Clin Pharm. 2017;39(1):16-25. doi: 10.1007/s11096-016-0414-2.
18. Lopez-Medina A.I., Chahal C.A.A., Luzum JA. The genetics of drug-induced QT prolongation: evaluating the evidence for pharmacodynamic variants. Pharmacogenomics. 2022;23(9):543-557. doi: 10.2217/pgs-2022-0027.
19. Valentin J.P., Hoffmann P., Ortemann-Renon C., Koerner J., Pierson J., Gintant G., Willard J., Garnett C., Skinner M., Vargas H.M., Wisialowski T., Pugsley M.K. The Challenges of Predicting Drug-Induced QTc Prolongation in Humans. Toxicol Sci. 2022;187(1):3-24. doi: 10.1093/toxsci/kfac013.
20. Masnoon N., Shakib S., Kalisch-Ellett L., Caughey G.E. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230. doi: 10.1186/s12877-017-0621-2.
21. Li D., Chai S., Wang H., Dong J., Qin C., Du D., Wang Y., Du Q., Liu S. Drug-induced QT prolongation and torsade de pointes: a real-world pharmacovigilance study using the FDA Adverse Event Reporting System database. Front Pharmacol. 2023;14:1259611. doi: 10.3389/fphar.2023.1259611.
22. Kahlon S.S., Sikandar R., Tejovath S., Nair S., Hassan D., Patel K., Peddemul A., Mostafa J.A. Diagnosing Torsades De Pointes Based on Correlation to QT Interval: A Systematic Review. Cureus. 2022;14(8):e27833. doi: 10.7759/cureus.27833.
23. Berger F.A., van der Sijs H., van Gelder T., van den Bemt P.M.L.A. The use of a clinical decision support tool to assess the risk of QT drug-drug interactions in community pharmacies. Ther Adv Drug Saf. 2021;12:2042098621996098. doi: 10.1177/2042098621996098.
24. Tay K.Y., Ewald M.B., Bourgeois F.T. Use of QT-prolonging medications in US emergency departments, 1995-2009. Pharmacoepidemiol Drug Saf. 2014;23(1):9-17. doi: 10.1002/pds.3455.
25. Chaverri-Fernández J.M., Díaz-Madriz J.P., Zavaleta-Monestel E., Cordero-García E., Fallas-Mora A., Escalona-Rodríguez R. The risk of treatment-induced QT interval prolongation. Farm Hosp. 2022;46(3):116-120..
26. Mangona E., Sandonato E., Brothers T.N., Pawasauskas J. Drug-Induced QTc Prolongation: What We Know and Where We Are Going. Curr Drug Saf. 2022;17(2):100-113. doi: 10.2174/1574886316666210922153059.
27. Wolfes J., Sörgel R., Ellermann C., Frommeyer G., Eckardt L. Mechanisms underlying spontaneous termination of Torsade de Pointes in an experimental model of long QT syndrome. Heart Rhythm. 2024:S1547-5271(24)03423-4. doi: 10.1016/j.hrthm.2024.10.009.
28. Uchikawa M., Hashiguchi M., Shiga T. Drug-Induced QT Prolongation and Torsade de Pointes in Spontaneous Adverse Event Reporting: A Retrospective Analysis Using the Japanese Adverse Drug Event Report Database (2004-2021). Drugs Real World Outcomes. 2022;9(4):551-559. doi: 10.1007/s40801-022-00328-0.
29. Tisdale J.E., Chung M.K., Campbell K.B., Hammadah M., Joglar J.A., Leclerc J., Rajagopalan B.; American Heart Association Clinical Pharmacology Committee of the Council on Clinical Cardiology and Council on Cardiovascular and Stroke Nursing. Drug-Induced Arrhythmias: A Scientific Statement From the American Heart Association. Circulation. 2020;142(15):e214-e233. doi: 10.1161/CIR.0000000000000905.
30. Giudicessi J.R., Noseworthy P.A., Friedman P.A., Ackerman M.J. Urgent Guidance for Navigating and Circumventing the QTc-Prolonging and Torsadogenic Potential of Possible Pharmacotherapies for Coronavirus Disease 19 (COVID-19). Mayo Clin Proc 2020; 95: 1213-1221. doi: 10.1016/j.mayocp.2020.03.024.
31. Thu Kyaw M., Maung Z.M. Hypokalemia-Induced Arrhythmia: A Case Series and Literature Review. Cureus. 2022;14(3):e22940. doi: 10.7759/cureus.22940.
32. Vehmeijer J.T., Koyak Z., Leerink J.M., Zwinderman A.H., Harris L., Peinado R., Oechslin E.N., Robbers-Visser D., Groenink M., Boekholdt S.M., de Winter R.J., Oliver J.M., Bouma B.J., Budts W., Van Gelder I.C., Mulder B.J.M., de Groot J.R. Identification of patients at risk of sudden cardiac death in congenital heart disease: The PRospEctiVE study on implaNTable cardIOverter defibrillator therapy and suddeN cardiac death in Adults with Congenital Heart Disease (PREVENTION-ACHD). Heart Rhythm. 2021;18(5):785-792. doi: 10.1016/j.hrthm.2021.01.009.
33. Robison L.B., Brady W.J., Robison R.A., Charlton N. QT interval prolongation and the risk of malignant ventricular dysrhythmia and/or cardiac arrest: Systematic search and narrative review of risk related to the magnitude of QT interval length. Am J Emerg Med. 2021;49:40-47. doi: 10.1016/j.ajem.2021.05.032.
34. Santoro F., Monitillo F., Raimondo P., Lopizzo A., Brindicci G., Gilio M., Musaico F., Mazzola M., Vestito D., Benedetto R.D., Abumayyaleh M., El-Battrawy I., Santoro C.R., Di Martino L.F.M., Akin I., De Stefano G., Fiorilli R., Cannone M., Saracino A., Angarano S., Carbonara S., Grasso S., Di Biase L., Brunetti N.D. QTc Interval Prolongation and Life-Threatening Arrhythmias During Hospitalization in Patients With Coronavirus Disease 2019 (COVID-19): Results From a Multicenter Prospective Registry. Clin Infect Dis. 2021;73(11):e4031-e4038. doi: 10.1093/cid/ciaa1578.
35. Shah S.R., Park K., Alweis R. Long QT Syndrome: A Comprehensive Review of the Literature and Current Evidence. Curr Probl Cardiol. 2019;44(3):92-106. doi: 10.1016/j.cpcardiol.2018.04.002.
36. Velcea A.E., Mihaila Baldea S., Nicula A.I., Vinereanu D. The role of multimodality imaging in the selection for implantable cardioverter-defibrillators in heart failure: A narrative review. J Clin Ultrasound. 2022;50(8):1066-1072. doi: 10.1002/jcu.23281.
37. Donnellan E., Wazni O.M., Hanna M., Saliba W., Jaber W., Kanj M. Primary prevention implantable cardioverter-defibrillators in transthyretin cardiac amyloidosis. Pacing Clin Electrophysiol. 2020;43(11):1401-1403. doi: 10.1111/pace.14023.
38. Khan K., Kim J.A., Gurgu A., Khawaja M., Cozma D., Chelu M.G. Innovations in Cardiac Implantable Electronic Devices. Cardiovasc Drugs Ther. 2022;36(4):763-775. doi: 10.1007/s10557-021-07163-5.
39. Biton Y., Rosero S., Moss A.J., Goldenberg I., Kutyifa V., McNitt S., Polonsky B., Baman J.R., Zareba W. Primary prevention with the implantable cardioverter-defibrillator in high-risk long-QT syndrome patients. Europace. 2019;21(2):339-346. doi: 10.1093/europace/euy149.
40. Ahsan S., Tousoulis D., Papageorgiou N. Implantable cardioverter-defibrillators: The shock "Paradox". Hellenic J Cardiol. 2020;61(6):428-429. doi: 10.1016/j.hjc.2020.12.005.