Heart conduction disorders related to antimalarials toxicity: an analysis of electrocardiograms in 85 patients treated with hydroxychloroquine for connective tissue diseases

被引:109
作者
Costedoat-Chalumeau, N.
Hulot, J.-S.
Amoura, Z.
Leroux, G.
Lechat, P.
Funck-Brentano, C.
Piette, J.-C.
机构
[1] CHU Pitie Salpetriere, Ctr Reference Natl Lupus & Syndrome Antiphospholi, AP HP, Serv Med Interne Prof Piette, F-75651 Paris 13, France
[2] CHU Pitie Salpetriere, Ctr Reference Natl Lupus & Syndrome Antiphospholi, AP HP, Serv Pharmacol, F-75651 Paris 13, France
[3] Univ Paris 06, Dept Pharmacol, INSERM, Clin Invest Ctr, F-75012 Paris, France
[4] St Antoine Univ Hosp, AP HP, Dept Pharmacol, F-75012 Paris, France
关键词
hydroxychloroquine; antimalarials; atrioventricular block; electrocardiogram; toxicity; heart conduction disorders;
D O I
10.1093/rheumatology/kel402
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. The antimalarial agents chloroquine (CQ) and hydroxychloroquine (HCQ) are used in long-term treatment of connective tissue diseases (CTDs). A high incidence of heart conduction disorders, including bundle-branch block and incomplete or complete atrioventricular block, has been observed among patients treated with CQ. Since no data were available for HCQ, we studied electrocardiograms (ECGs) in 85 unselected patients with CTD treated with HCQ as the sole antimalarial. Methods. Eighty-five unselected out-patients treated with HCQ for a minimum of 1 yr, and without established cardiac diseases had standard 12-lead ECGs. Results. Two incomplete right bundle-branch blocks and one left bundle-branch block were observed. No atrioventricular block was observed. The mean PR interval was 137 +/- 20 ms (range 99-188). The mean QTc interval was 410 ms (range 349-464). The mean heart rate was 73 beats/min (range 53-102). Conclusion. PR interval, QTc interval and heart rate were not different from normal values. The rate of heart conduction disorders was similar to what is expected in the general population, and contrasted with prior results in CQ-treated patients. Our results add further evidence on the safety of HCQ compared with CQ.
引用
收藏
页码:808 / 810
页数:3
相关论文
共 18 条
  • [1] HISTOLOGICAL AND ULTRASTRUCTURAL FINDINGS IN CHLOROQUINE-INDUCED CARDIOMYOPATHY
    AUGUST, C
    HOLZHAUSEN, HJ
    SCHMOLDT, A
    POMPECKI, R
    SCHRODER, S
    [J]. JOURNAL OF MOLECULAR MEDICINE-JMM, 1995, 73 (02): : 73 - 77
  • [2] Chloroquine cardiomyopathy with conduction disorders
    Baguet, JP
    Tremel, F
    Fabre, M
    [J]. HEART, 1999, 81 (02) : 221 - 223
  • [3] Chronic hydroxychloroquine use associated with QT prolongation and refractory ventricular arrhythmia
    Chen, CY
    Wang, FL
    Lin, CC
    [J]. CLINICAL TOXICOLOGY, 2006, 44 (02) : 173 - 175
  • [4] Cardiomyopathy related to antimalarial therapy with illustrative case report
    Costedoat-Chalumeau, Nathalie
    Hulot, Jean-Sebastien
    Amoura, Zahir
    Delcourt, Annick
    Maisonobe, Thierry
    Dorent, Richard
    Bonnet, Nicolas
    Sable, Regis
    Lechat, Philippe
    Wechsler, Bertrand
    Piette, Jean-Charles
    [J]. CARDIOLOGY, 2007, 107 (02) : 73 - 80
  • [5] Low blood concentration of hydroxychloroquine is a marker for and predictor of disease exacerbations in patients with systemic lupus erythematosus
    Costedoat-Chalumeau, Nathalie
    Amoura, Zahir
    Hulot, Jean-Sebastien
    Abou Hammoud, Hala
    Aymard, Guy
    Cacoub, Patrice
    Frances, Camille
    Wechsler, Bertrand
    Huong, Du Le Thi
    Ghillani, Pascale
    Musset, Lucile
    Lechat, Philippe
    Piette, Jean-Charles
    [J]. ARTHRITIS AND RHEUMATISM, 2006, 54 (10): : 3284 - 3290
  • [6] Electrocardiogram reference ranges derived from a standardized clinical trial population
    Dmitrienko, AA
    Sides, GD
    Winters, KJ
    Kovacs, RJ
    Rebhun, DM
    Bloom, JC
    Groh, W
    Eisenberg, PR
    [J]. DRUG INFORMATION JOURNAL, 2005, 39 (04): : 395 - 405
  • [7] Easterbrook M, 1999, J RHEUMATOL, V26, P1866
  • [8] Estes M L, 1987, Am J Med, V82, P447, DOI 10.1016/0002-9343(87)90444-X
  • [9] Natural history of isolated bundle branch block
    Fahy, GJ
    Pinski, SL
    Miller, DP
    McCabe, N
    Pye, C
    Walsh, MJ
    Robinson, K
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1996, 77 (14) : 1185 - 1190
  • [10] CARDIOMYOPATHY TREATED WITH HYDROXYCHLOROQUINONE IN THE PRESENCE OF COMPLETE AV BLOCK
    FELLAHI, JL
    DUMAZER, P
    DELAYANCE, S
    VERNIER, I
    CONTE, JJ
    [J]. REVUE DE MEDECINE INTERNE, 1993, 14 (04): : 275 - 276