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Desmethylimipramine and imipramine on left ventricular function and the ECG: a randomized crossover design
International Journal of Cardiology
|January 1, 1983
Summary
This study found that desmethylimipramine and imipramine equally affect cardiac function in depressed patients. Echocardiograms are more reliable than systolic time intervals for assessing myocardial performance during tricyclic antidepressant therapy.
Area of Science:
- Cardiology
- Psychiatry
- Pharmacology
Background:
- Tricyclic antidepressants like imipramine and desmethylimipramine are commonly prescribed for depression.
- Their effects on cardiac function, particularly left ventricular function and electrocardiogram (ECG) parameters, require thorough investigation.
Purpose of the Study:
- To compare the effects of desmethylimipramine and imipramine on left ventricular function and ECG in severely depressed patients.
- To evaluate the reliability of systolic time intervals versus echocardiography in assessing myocardial performance during treatment with these antidepressants.
Main Methods:
- A double-blind, randomized, crossover study involving 16 severely depressed patients.
- Patients received 3 weeks of therapy with desmethylimipramine and imipramine, separated by a drug-free week.
- Systolic time intervals, echocardiograms, and high-fidelity ECGs were recorded during each treatment period.
Main Results:
- No significant differences were observed between desmethylimipramine and imipramine regarding systolic time intervals, shortening fraction, mean velocity of circumferential shortening, or overall ECG parameters.
- Both drugs significantly altered pre-ejection period (PEP), PEP/LVET ratio, and several ECG intervals (R-R, PR, QRS, QTc) compared to the drug-free period.
- Echocardiography provided a more reliable assessment of myocardial performance than systolic time intervals in patients receiving these tricyclic antidepressants.
Conclusions:
- Desmethylimipramine and imipramine exhibit similar effects on cardiac function and ECG parameters in depressed patients.
- Prolongation of intraventricular conduction by these drugs is associated with prolonged PEP and PEP/LVET.
- Echocardiography is recommended for assessing myocardial performance in patients treated with tricyclic antidepressants due to the limitations of systolic time intervals.