Are there any differences between stress hormone levels in non-stress conditions and in potentional stress overload (heart catheterisation) in sows?

In order to study a possible effect of mini-invasive heart intervention on a response of hypothalamo-pituitary-adrenal stress axis, we analyzed four stress markers (cortisol, cortisone, DHEA and DHEAS) in 25 sows using minimally invasive heart catheterisation as the stress factor. The marker levels were assessed in four periods of the experiment, (1) the baseline level on the day before intervention, (2) after the introduction of anesthesia, (3) after conducting tissue stimulation or ablation, and (4) after the end of the catheterisation. For statistical analyses we used the non-parametric Friedman test for four dependent samples (including all four stages of the operation) or three dependent samples (influence of operation only, baseline level was excluded). Statistically significant differences in both Friedman tests were found for cortisol and for cortisone. Significant differences for DHEA as well as for DHEAS were found for all tested stages but not for the effect of operation itself. We have concluded that cortisol levels are blunted by the influence of anesthesia after its administration, and therefore decrease back to the baseline at the end of the operation. The other markers (cortisone, DHEA and DHEAS) acted as balanced systems against the injurious stress effect.

[Molecular cytogenetic analysis of chromosomal aberrations in cells of low grade gliomas and its contribution for tumour classification]. / Molekulárne cytogenetická analýza chromozomových aberací v bunkách nízkostupnových gliomu a její prínos pro klasifikaci nádoru.

BACKGROUND: Low-grade gliomas represent a heterogeneous group of primary brain malignancies. The current diagnostics of these tumors rely strongly on histological classification. With the development of molecular cytogenetic methods several genetic markers were described, contributing to a better distinction of glial subtypes. The aim of this study was to assess the frequency of acquired chromosomal aberrations in lowgrade gliomas and to search for new genomic changes associated with higher risk of tumor progression. PATIENTS AND METHODS: We analysed biopsy specimens from 41 patients with histological dia-gnosis of low-grade glioma using interphase fluorescence in situ hybridization (I FISH) and single nucleotide polymorphism (SNP) array techniques (19 females and 22 males, medium age 42 years). RESULTS: Besides notorious and most frequent finding of combined deletion of 1p/ 19q (81.25% patients) several other recurrent aberrations were described in patients with oligodendrogliomas: deletions of p and q arms of chromosome 4 (25% patients), deletions of the short arms of chromosome 9 (18.75% patients), deletions of the long arms of chromosome 13 and monosomy of chromosome 18 (18.75% patients). In bio-psy specimens from patients with astrocytomas, we often observed deletion of 1p (24% patients), amplification of the long arms of chromosome 7 (16% patients), deletion of the long arm of chromosome 13 (20% patients), segmental uniparental disomy (UPD) of the short arms of chromosome 17 (60% patients) and deletion of the long arms of chromosome 19 (28% patients). In one patient we detected a shuttered chromosome 10 resulting from chromothripsis. CONCLUSION: Using a combination of I FISH and SNP array, we detected not only known chromosomal changes but also new or less frequent recur-rent aberrations. Their role in cancer  cell progression and their impact on low grade gliomas classification remains to be elucidated in a larger cohort of patients.

QT dispersion and electrocardiographic changes in women with gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) represents additional risks to both mother and infant. Moreover it increases a woman's risk of cardiovascular disease in the postpartum. The aim of our study was therefore to detect changes of both the QT dispersion and the electrical heart field that could be typical for GDM. Body surface potential maps were obtained using the Cardiac 112.2 device from 26 young women with GDM and 54 young healthy pregnant women in the 36th week of pregnancy. The same recordings were obtained from 18 healthy women in the same age (19-36 years). The average QT dispersion (±SD) in women suffering from GDM was significantly higher (107 ± 25 ms) both than in those with physiological pregnancy (73 ± 18 ms) and than in the normal subjects (34 ± 12 ms) (P<0.001). Moreover we have found in GDM patients shorter QRS complex 82.0 ± 6.8 ms vs. 89.5 ± 8.2 ms in healthy pregnant women and 90.8 ± 7.9 ms in the control group (p=0.011), more horizontal electrical heart axis [16.4 ± 20.1° vs. 42.4 ± 28.7° and 74.6 ± 39.2° respectively (P<0.05)] and lower some depolarization and repolarization amplitudes on isopotential and isointegral maps. According to these results we suppose that described electrocardiographic changes reflect a deterioration of the complete process of ventricular depolarization and repolarization in GDM.

[Validity of the oncological cytodiagnostics and colposcopy examination versus biopsy in cervical carcinoma prevention]. / Validita onkologické cytodiagnostiky a kolposkopie versus biopsie v prevenci rakoviny cervixu.

THE AIM OF THE STUDY: The basic praebioptic methods detecting the precancerous lesions of the uterine cervix are oncologic cytology (PAP smears) and colposcopy. However in the Czech Republic the incidence of the invasive carcinomas during the last 10 years did not considerably decrease. Therefore the goal of our study is to estimate the validity of the prebioptic methods and compare the results of praebioptic methods (procedures) versus biopsy. TYPE OF THE STUDY: Analysis of the results of the oncologic cervical cytology comparing with the results of cervical biopsies performed during the years 2002-2003 were compared to those of the year 2009. THE SUBJECT AND METHODS OF THE STUDY: evaluation of the prebioptic methods (cytology, colposcopy) versus biopsy prior and during the start of the National Screening in the Czech Republic. SETTING: 1. Centre for Gynaecological Oncological prevention, 1st Faculty of Medicine, Charles University Prague, Department of Gynaecology and Obstetrics. 2. Institute of Physiology, Department of cybernetics, 1st Faculty of Medicine, Charles University, Prague. 3. Institute of Pathology, University of Ostrava. 4. Institue for Mother and Child Care, Prague. SUMMARY: We screened the documentation related to the treatment of 423 women with cervical lesions, examined at the Oncological prevention centre of the Obstetrical and Gynaecological Department of the 1st Faculty of Medicine Charles University Prague and the General Teaching Hospital in Prague 2. Results of the oncologic cytology, colposcopy and biopsy were compared. The comparison revealed differences related to the time of examinations. During the years 2002 and 2003 the agreement between cytologic diagnosis and biopsies in the group of HSIL was 40 %. In the year 2009 the agreement between HSIL and CIN was 68% the colposcopic diagnosis of precancerous lesions with those of bioptic specimens, during the years 2002 and 2003 was 90% while in the year 2009, during the National Screening, the agreement reached 98%.

[Invasive cervical cancer incidence in the span from the preventive check-up to the national screening programing in the Czech Republic]. / Invazivní karcinom cervixu od depistázních akcí k národnímu screeningu v Ceské republice.

OBJECTIVE: Former Czechoslovakia was the first European country in which the gynecological cytodiagnosticts was used for checking-up the cervix malignancy, in the years 1947-1957. The preventive measures in woman population together with building up the centres for gynekological oncological prevention result in the cervical cancer incidence lowering, as it is documented by national registry data. The cervical cancer incidence rate was 19.2/100 000 in the year 2008, that is the third endplace on the European scale. How to go positively forward? SETTING: 1st Faculty of medicine, Charles University Prague and General Teaching Hospital Prague. STUDY DESIGN: Analytical study od the incidence during the historical way up to now. Validity of the data should bring the strategy of solution. METHODS: The collected data od the cervical cancer incidence provided by national registry of the CR from the span 1960 to 2008 enabled to evaluate the effectivity od prevention measures used. RESULTS: The incidence rate od cervical cancer was 30/100 000 women before the prevention check-up started. the diagnosis was based cytology. The incidence of cervical cancer lowered to 22/100 000 in the year 1970. The establishment of the centres for oncological gynekological prevention ("COP") led up to the futher dropping up of cervical cancer incidence (20,7/100 000) the activity of the "COP" was based on the gynekologists having the II. degree certificate of the line, colposcopy skill, on cytolaboratory. The continuing education of cytotechnologists started in the year 1991 and it has influenced positively the cervical cancer incidence - its rate was below 20/100 000 -in the year 2008. the data analyses have shown, that the west regions of the CR (Karlovy Vary, Ustí nad Labem) have high incidence steadely respectively. The graph of incidence of age groups of women has 3 peaks: In the age 35-39, 55-59 and 75-80. The whole Moravia region reached the lowest cervical cancer incidence 15,2/100 000, which is lower then the world incidence standard. The Czech part of the republic has shown 20,7/100 000 in the average in the year 2008.

Might cardiac catheterization influence diurnal rhythm of the steroid stress hormones secretion?

Glucocorticoids (GCs) are steroid hormones produced by the adrenal cortex in reaction to stress stimuli. GCs production is not stable over a 24-hour period; the plasma concentration peaks in the morning (approximately upon awakening) and then the plasma levels decrease, reaching the nadir in the evening. In our experiments, the levels of cortisol, cortisone, DHEA and DHEAS were tested in young female pigs (n=23) during heart catheterization at two different day times (in the morning and in the afternoon). The non-parametric Mann-Whitney test for statistical analysis was used. We found only minimal statistical differences in studied markers between the morning and afternoon group (p>0.05). The absence of circadian variation in GCs levels could originate either at an early age of our experimental pigs, or in stressful conditions on the experiment day, or most likely the day before (e.g. social isolation, fasting, transport, and catheterization), respectively. We can conclude there is no difference in the stress load between morning and afternoon experiments, and therefore we can assume the stress load is not a limiting factor for the timing when catheterization should be preferably performed.

Nicotine influences the motor performance of immature rats in two different sensorimotor tasks.

The aim of this study was to assess the effect of nicotine on motor performance of immature (12-day-old) rats. We used two sensorimotor tasks (surface righting response and negative geotaxis test) to evaluate the influence of nicotine on animal's motor activity in course of 24 hours. Animals were treated intraperitoneally with two different nicotine doses (0.5 mg/kg and 1.0 mg/kg) and tested in four sessions (1 minute, 10 minutes, 1 hour and 24 hours after the injection). We concluded that nicotine significantly influences the motor behaviour in 12-day-old rats and this effect is dose dependent.

Is there circadian variation in cortisol levels in young sows in heart catheterization?

Cortisol is the main glucocorticoid (GC) hormone in pigs associated with stress response. It is well known that GCs levels are not stable during the day; their concentration is a circadian variable with the peak in the morning and the nadir in the night (in diurnal animals). Circadian variation is present during postnatal ontogeny. The onset of the circadian fluctuation occurs in pigs at the age of 3 to 20 weeks (according to the literature). The aim of our pilot study was to determine if young sows (used in cardiosurgical experiments) already developed the circadian variation. Twelve-week-old sows were used in the heart catheterization experiment. Cortisol was measured during four different stages of the experiment at two different times of the day (the operation was performed in the morning or afternoon). To determine circadian variation the Mann-Whitney test was used; to determine changes in cortisol levels within the experiment the Friedman test was performed. We didn't find any circadian variation (p>0.05) or statistical significant variation in the Friedman test (p>0.05). We assumed that our pigs are too young to have circadian rhythm present. Our findings are in accordance with many authors.

The comparison of methods for determination of humoral and cell-mediated immunity in patients with breast cancer.

We observed the immunological answer to antigens obtained from the human malignant breast tumor and from the blood of inbred mice strain C3H/H2K infected by LDH virus. We compared the modified ELISA method for humoral immunity with the leukocyte adherence inhibition (LAI) assay for cell-mediated immunity. The modified ELISA method is suitable for early diagnosing and monitoring antibodies in a malignant breast tumor simultaneously with senological examinations which include mammography and clinical examinations, because the antibodies are determined in a high number of samples by single application.

Cell-mediated immunity in cervical cancer evolution.

Cell-mediated immunity (CMI) response to different antigens was examined in healthy women, in patients with cervical precancerous lesions, and in patients with cervical cancer. Cervical lesions were diagnosed by cytological (PAP) smears, from examination by colposcopy, and from "punch" biopsy material by histology. CMI response is related to specific processes in healthy and cancer cells. CMI was investigated by leukocyte adherence inhibition (LAI) assay using specific antigen (prepared from cervical carcinoma tissue) and non specific antigen (prepared from blood of mice infected by LDH--lactate dehydrogenase--virus). The CMI responses of healthy women and cancer patients to the antigens used are different: the majority of T lymphocytes display adherence and non adherence, respectively (but the CMI responses elicited by the antigens are not equal and small quantitative differences are observed). Regardless of the CIN (cervical intraepithelial neoplasia) grades, CMI responses correspond either to healthy women or to cervical carcinoma patients (at about similar ratio of cases in all the CIN groups). Effect of non specific antigen suggests that cervical carcinoma transformation may be connected with reduction of mitochondrial activity similar to processes in LDH virus infection.

Prevalence of tidal expiratory flow limitation in preschool children with and without respiratory symptoms: application of the negative expiratory pressure (NEP) method.

Negative expiratory pressure (NEP) applied at the mouth during tidal expiration provides a non-invasive method for detecting expiratory flow limitation. Forty-two children were studied, i.e. 25 children with different respiratory symptoms (R) and 17 without any respiratory symptoms (NR). Children were examined without any sedation. A preset NEP of -5 cm H(2)O was applied; its duration did not exceed duration of tidal expiration. A significance of FL was judged by determining of a flow-limited range (in % of tidal volume). FL was found in 48 % children of R group. No patient of the NR group elicited FL (P<0.001 R vs. NR). The frequency of upper airway collapses was higher in R group (12 children) than in NR group (5 children). In conclusion, a high frequency of tidal FL in the R group was found, while it was not present in NR group. A relatively high frequency of expiratory upper airway collapses was found in both groups, but it did not differ significantly. NEP method represents a reasonable approach for tidal flow limitation testing in non-sedated preschool children.

Changes of leukocyte adherence ability under the influence of magnetic field in the course of a treatment of patients with laryngeal and pharyngeal carcinoma.

The authors were monitoring adherence ability of T lymphocytes in vitro in patients with laryngeal and pharyngeal carcinoma at the presence of tumor-specific and viral LDH antigen. The results were assessed and expressed in percent of non adherent T lymphocytes (NAL). First, NAL in patients before initiating the treatment was compared with NAL control group (voluntary blood donors). The ability of the adherence in T lymphocytes in the control group is statistically significantly higher. Further on, NAL in the course of a successful oncological treatment was monitored at the interval of 6 months following the treatment, and further on at yearly intervals. NAL level drops statistically significantly within 6 months and then hold on at levels with no statistical difference unlike the control group, however, the ability of T lymphocyte in patients to adhere remains statistically significantly lower. Statistically significantly higher levels of NAL are at the presence of LDH viral antigen. Further on, the authors were following the influence of magnetic sinusoidal field of power frequency (50 Hz) of a low induction (0.5, 0.1, and 0.05 mT) on NAL. NAL values under the influence of an experimental magnetic field before initiating the treatment as well as in the course of a successful oncological treatment are statistically significantly lower. It means that magnetic filed increases the adherence ability of T lymphocytes in patients with laryngeal and pharyngeal cancer in vitro.

Uterine arteries doppler velocimetry provides 3-years follow up endometrial ablation outcome.

The aim of this study was to assess whether uterine artery Doppler velocimetry [pulsatility index (PI) and resistance index (RI)] and thickness of the endometrium (TE) are able to predict 3-year clinical outcome after endometrial ablation (EA) for dysfunctional uterine bleeding (DUB). This was a prospective, observational study of 29 women of whom 22 were amenorrhoeic (A) and 7 eumenorrhoeic (E) at the end of the first postoperative year. The PI, RI and TE were measured prior to and 1, 6 and 12 months after EA. Statistical analyses were performed using BMDP statistical software, discriminant analysis, ANOVA and T test. Using the calculated classification function (CF) with the three parameters PI, RI and TE measured 12 months after FEAT, we were able to accurately (100%) specify which of the women will have A or E in 3 years. The predictive value of PI, RI and TE has been confirmed clinically in a minimum 3-year follow-up of outcome (ranging from 36 to 72 months [mean 55]). All A and E women have stayed in the same group (A or E) during the minimum of 3 years. In conclusion we found that PI, RI and TE measured prior to EA cannot predict the outcome, however these measurements performed 1 year after FEAT can predict the duration of A or E in the 3-year follow up.

[Comparison of various types of pharmacological prevention of lower extremities deep vein thrombosis in patients with proximal femoral fractures]. / Porovnání ruzných typu farmakologické prevence hluboké zilní trombózy dolních koncetin u pacientu se zlomeninou proximální Cásti stehenní kosti.

Adminstration of coagulation-active substances is one of the options to prevent thromboemboembolic disease (TED), including deep vein thrombosis and systemic response to stress entailed by an injury or a surgical procedure. Lately, a synthetic analogue of the heparin molecule--of its functionally active part--pentasaccharide (PS), has been developed, among others. Potential effects of different pharmacopreventive therapies of the deep vein thrombosis was studied in a group of 146 subjects, who suffered proximal femoral fractures and were operated in the Ist Surgical Clinic, VFN Hospital, during 2001-2006. The patients were randomized into 4 different anticoagulant groups (UFH, LMWH, PS short-term and PS long-term). Thromboembolic symptoms, selected postoperative complications and laboratory findings of selected blood count parameters, coagulation, active phase proteins and adhesion molecules, were monitored. The results indicate existing increased risk of the deep vein thrombosis and a lower rate of the coagulation and fibrinolytic cascade activation, suggesting a higher rate of the hemostatic status stability in the pentasaccharide groups, especially in the groups receiving the long-term pentasaccharide medication (over a month). Therefore, potential pentasaccharide protective effect preventing development of the deep vein thrombosis may be expected.

Serum copper as a marker of inflammation in prediction of short term outcome in high risk patients with chronic heart failure.

BACKGROUND: Oxidative process and inflammation are regarded as important factors in the pathogenesis of chronic heart failure. Our study was aimed at investigating the prognostic value of serum copper levels in high risk subjects with chronic heart failure. METHODS: Serum copper levels and other prognostic indicators were determined in the group of 60 patients with chronic heart failure due to ischemic heart disease: 30 consecutive subjects with acute decompensation of chronic heart failure (acute group A) and 30 patients with chronic stable heart failure (group B). Patients were followed prospectively 12 months. Primary end-point was the mean time to death and/or heart failure hospital admission. RESULTS: The mean time to death was in the group A 279.4+/-18.9 days and 351.7+/-13.6 days in the group B (p<0.0001). Cox proportional hazard model revealed that the time to death for all subjects (n=60) was affected by cardiothoracic ratio (p<0.001). The time to combined end-point death or hospital admission was affected by serum copper concentration (p<0.0001). CONCLUSION: Serum copper levels predicted short term outcome in high risk patients with chronic heart failure.

Prospective use of EuroSCORE for the short-term risk evaluation of consecutive cardiac surgery candidates: are there any differences in prediction of perioperative risk versus risk of nonsurgical treatments?

BACKGROUND: In the era of modern medicine, the relevance of perioperative risk stratification with respect to the practice of cardiac surgeons and cardiologists worldwide has increased. AIM: This study aims at estimating the validity of a preoperative risk stratification model EuroSCORE in predicting short-term mortality in Czech adult cardiac population. METHODS: All consecutive patients (n = 460) presented to cardiac surgeons as surgery candidates during a six-month period were enrolled in this study. The Additive and logistic EuroSCORE were used for the risk assessment. The operative mortality, as well as the mortality within 30 days from discharge were recorded. The observed and predicted mortality derived from the EuroSCORE were compared. RESULTS: Fifty-seven percent of the patients underwent cardiac surgery, while 43% was refused for surgery by the cardiac surgeon. There was no significant difference between the observed and predicted mortality in both subgroups. EuroSCORE showed good discriminatory ability in predicting short-term mortality (C statistic 0.755 vs. 0.762 for the surgery subgroup and 0.695 vs. 0.716 for the refused subgroup). CONCLUSIONS: The EuroSCORE has a good discriminatory ability in predicting early mortality after cardiac surgery as well as in patients rejected for cardiac surgery. Both EuroSCORE risk prediction model forms are a suitable mortality predictor in Czech cardiac patients.

Lipoperoxidative activities in the cerebral cortex and medulla oblongata, related to age, sex, oxygen deficiency and short-term fasting.

In albino rats (Wistar), aged 10 and 14-days of postnatal life, experiments were performed, in which the intensity of lipoperoxidative processes in cerebral cortex and medulla oblongata in four experimental series was measured and compared: a) between females and males (control group); b) between females and males exposed to the hypobaric hypoxia (corresponding to the altitude of 7000 m and lasting 20 minutes); c) between females and males exposed to the short-term starvation (for 24 h between the day 5th and 6th of postnatal life); d) between females and males exposed to the combination of short-term starvation and hypobaric hypoxia. No sex-dependent differences in control measurements could be detected. The hypobaric hypoxia evokes significantly greater increase in lipoperoxidative processes in brain tissue of males as compared with females. The short-term starvation affected more the oxygen radicals production in the brain of females. Finally--the short-term starvation and the subsequent hypoxic stress did not evoke the sex-dependent differences in the brain of 10-day-old rats; in 14-day-old females the higher values in brain cortex, in males higher values in medulla oblongata were established. The different sensitiveness to mentioned stressors in males (more sensitive to oxygen deficiency) and in females (more sensitive to nutritional deficiency) was described.

[The effect of posthypoxic hypothermia for lactate dehydrogenase activity in brain cortex and blood serum of 14-days-old rats]. / Vliv a význam hypoxie a následné hypotermie na aktivitu laktátdehydrogenázy v mozkové kure a v krevním séru u 14denních laboratorních potkanu.

OBJECTIVE: The effect of various degrees of hypobaric hypoxia and consequent hypothermia on lactate dehydrogenase (E.C.1.1.1.27) activity in blood serum and brain cortex in 14 day-old rats was investigated. DESIGN: Experimental study. SETTING: Institute of Physiology, 1st Med. Faculty, Charles University, Prague. METHODS: 14 day-old rats (Wistar of our own breed) were exposed to mild hypobaric hypoxia (corresponding to altitude of 7000 m, pO2 = 8.6 kPa, BP = 41.2 kPa, lasting 20 min) or strong hypobaric hypoxia (corresponding to altitude of 9000 m, pO2 = 6.4 kPa, BP = 30.7 kPa, lasting 30 min). Just after hypoxic stress the animals were killed by decapitation and on cooled block the grey cortical matter was removed. Blood serum samples as well as brain cortex homogenates were immediately incubated in three variously tempered media (38 degrees Celsius = control values, 30 degrees Celsius and 22 degrees Celsius = hypothermic conditions). The incubation was over (30 min.), and the lactate dehydrogenase (LDH) activity was followed using the Lachema test. RESULTS: The LDH activity was influenced by mild hypobaric hypoxia (7000 m) neither in blood serum nor in brain cortex. Also the values of LDH activities registered in normo or in hypothermic conditions were not different as compared with control values. The strong hypoxia (9000 m) evokes in brain cortex homogenates simultaneously with normothermia and posthypoxic hypothermia (30 degrees Celsius) significant increase of LDH activity. In blood serum the strong hypoxia increased the LDH activity; in subsequent hypothermic condition (22 degrees Celsius) the LDH activity was more lowered. CONCLUSION: The LDH activity in brain cortex as well as in blood serum of young rats (Wistar) seems to be resistent to mild hypoxia (7000 m) as well to hypothermic conditions. The strong hypoxia (9000 m) evokes quite different responses: in brain cortex the LDH activities in hypothermic conditions are higher, in blood serum lower as compared with control values (14 day-old rats stressed by hypoxia only). In control measurements the lowering temperature decreases the mentioned enzyme activity in brain cortex; in blood serum no significant differences could be found.

QT dispersion estimated from 80 body surface potential map leads and from standard 12-leads ECG in psychiatric patients treated with dosulepin.

The aim of the study was to detect changes of the QT dispersion (QTd) due to cardiotoxicity of tricyclic antidepressant dosulepin. Electrocardiographic and body surface potential mapping (BSPM) recordings were obtained using Cardiag 112.2 diagnostic system from 27 psychiatric outpatients treated with prophylactic doses of dosulepin and compared to those obtained from 37 healthy volunteers. From these recordings the QTd and the dispersion of heart rate-corrected QT interval QTc were evaluated. These parameters were estimated both from 80 BSPM leads and from 12 standard ECG leads. Acquired data were statistically correlated by Spearman rank order correlation coefficient with dosulepin plasma levels. The average QTd evaluated from BSPM leads (+/-SD) in the dosulepin group was significantly higher [70 (+/-21) ms] than that in the control group [34 (+/-12) ms] (P< 0.001). Moreover, the correlation between QTd and the dosulepin plasma level was statistically significant as well (P< 0.001) with the value of correlation coefficient 0.7871. The QTd evaluated from standard 12 ECG leads was increased in dosulepin group as well [46 (+/-18) ms vs. 28 (+/-10) ms - P< 0.05] but we have not found any significant correlation of the QTd with the dosulepin plasma level. According to the above-mentioned results we can conclude that the QTd estimated from BSPM leads (but not that estimated from 12-lead ECG) could be used as a marker of the dosulepin effect on the myocardium.

QT dispersion and electrical heart field morphology in patients treated with dosulepin.

The aim of the study was to detect the changes of QT dispersion (QTd) due to cardiotoxicity of tricyclic antidepressant dosulepin. Electrocardiographic and vectorcardiographic recordings were obtained using Cardiag 112.2 diagnostic system from 28 psychiatric outpatients treated with prophylactic doses of dosulepin and compared to those obtained from 37 healthy volunteers. From these recordings following parameters were evaluated: QTd, spatial QRS-STT angle and amplitude of T-wave. The acquired data were correlated with the dosulepin plasma levels using Spearman's rank order correlation test. The average QTd (+/-S.D.) in the dosulepin group was significantly higher (70+/-21 ms) than that in the control group (34+/-12 ms) (P<0.001). Moreover, the correlation between QTd and the dosulepin plasma levels was highly significant (r = 0.7871, P<0.001). Similar results were obtained when QTc dispersion was used. On the contrary, the QRS-STT space angle did not correlate with the dosulepin plasma levels. Furthermore, the T-wave amplitude was not significantly correlated to the QT-interval. Thus we can conclude that the QT dispersion could be used as a simple marker of the dosulepin effect on the myocardium.