| Normalization of acquired QT prolongation in humans by intravenous potassium. | |
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MedLine Citation:
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PMID: 9337183 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: QT interval prolongation and dispersion have been implicated in serious arrhythmias in congestive heart failure (CHF) and the congenital and drug-induced long-QT syndromes (LQTS). In a subset of the congenital LQTS, infusion of potassium can correct QT abnormalities, consistent with in vitro increases in outward currents such as I(Kr) or I(Kl) when extracellular potassium concentration ([K+]o) is increased. Furthermore, increasing [K+]o decreases the potency of I(Kr)-blocking drugs in vitro. The purpose of this study was to test the hypothesis that increasing [K+]o corrects QT abnormalities in CHF and in subjects treated with quinidine. METHODS AND RESULTS: KCl (maximum, 40 mEq) was infused into (1) 12 healthy subjects treated with quinidine sulfate (5 doses of 300 mg/5 h) or placebo and (2) 8 CHF patients and age-matched normal control subjects. Mean [K+] increased from 4 to 4.2 mEq/L to 4.7 to 5.2 mEq/L. Potassium infusion significantly reversed QTUc prolongation, especially in the precordial leads (quinidine, 590+/-79 to 479+/-35 [+/-SD] ms(1/2), P<.001; CHF, 521+/-110 to 431+/-47 ms(1/2), P<.05). There was no effect in either control group. Similarly, potassium decreased QTUc dispersion (quinidine, 210+/-62 to 130+/-75 ms(1/2), P<.01; CHF, 132+/-68 to 84+/-35 ms(1/2), P=.07) and was without effect in the control subjects. QT morphological abnormalities, including U waves and bifid T waves, were reversed by potassium. CONCLUSIONS: Potentially arrhythmogenic QT abnormalities during quinidine treatment and in CHF can be nearly normalized by modest elevation of serum potassium. |
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Authors:
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A M Choy; C C Lang; D M Chomsky; G H Rayos; J R Wilson; D M Roden |
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Publication Detail:
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Type: Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Circulation Volume: 96 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1997 Oct |
Date Detail:
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Created Date: 1997-10-31 Completed Date: 1997-10-31 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2149-54 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn 37232-6602, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Electrocardiography / drug effects* Female Heart Failure / physiopathology* Humans Infusions, Intravenous Male Potassium / administration & dosage, blood, pharmacology* Potassium Chloride / administration & dosage, pharmacology Quinidine / pharmacology* Reference Values |
| Grant Support | |
ID/Acronym/Agency:
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GM-31304/GM/NIGMS NIH HHS; RR-00095/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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56-54-2/Quinidine; 7440-09-7/Potassium; 7447-40-7/Potassium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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