Download PDF
Pharmacopsychiatry 2019; 52(02): 92-93
DOI: 10.1055/a-0646-4278
Letter to the Editor
© Georg Thieme Verlag KG Stuttgart · New York

Evaluation of Myocardial Damage After Electroconvulsive Therapy: Analyses of High-Sensitive Cardiac Troponin I and N-Terminal pro-B-type Natriuretic Peptide

Laura Kranaster
1   Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
,
Johanna Badstübner
1   Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
,
Suna Su Aksay
1   Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
,
Jan Malte Bumb
2   Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
,
Rayan Suliman
3   Institute for Clinical Chemistry, University Medical Centre Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
,
Michael Neumaier
3   Institute for Clinical Chemistry, University Medical Centre Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
,
Alexander Sartorius
1   Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
› Author Affiliations
Further Information

Publication History

13 May 2018
revised   06 June 2018

accepted 19 June 2018

Publication Date:
02 July 2018 (online)

Also available at
    Permissions and Reprints

Abstract

Electroconvulsive therapy (ECT) is a remarkably safe procedure. However, there might exist a subgroup of patients with an increased risk for cardiovascular events. The cardiac-specific enzymes high-sensitive cardiac troponin I (hscTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured before and after ECT in 23 patients. No relevant increase of hscTnI after ECT was found. Mean NT-proBNP levels were higher after ECT and in three patients a new NT-proBNP elevation after ECT was identified. In conclusion, our small study did not find any evidence for myocardial damage due to ECT by measuring hsTnI, but an increase of NT-proBNP, whose clinical relevance could only be speculated, yet.

Key words

Electroconvulsive therapy - troponin - safety - side effects
 

  • References

  • 1 Torring N, Sanghani SN, Petrides G. et al. The mortality rate of electroconvulsive therapy: A systematic review and pooled analysis. Acta Psychiatr Scand 2017; 135: 388-397
    CrossrefPubMedGoogle Scholar
  • 2 Stoudemire A. Cardiovascular morbidity and ECT. Am J Psychiatry 1995; 152: 1697-1698
    CrossrefPubMedGoogle Scholar
  • 3 Steiner LA, Drop LJ, Castelli I. et al. Diagnosis of myocardial injury by real-time recording of ST segments of the electrocardiogram in a patient receiving general anesthesia for electroconvulsive therapy. Anesthesiology 1993; 79: 383-388
    CrossrefPubMedGoogle Scholar
  • 4 Gould L, Gopalaswamy C, Chandy F. et al. Electroconvulsive therapy-induced ECG changes simulating a myocardial infarction. Arch Intern Med 1983; 143: 1786-1787
    CrossrefPubMedGoogle Scholar
  • 5 Celano CM, Torri A, Seiner S. Takotsubo cardiomyopathy after electroconvulsive therapy: A case report and review. J ECT 2011; 27: 221-223
    CrossrefPubMedGoogle Scholar
  • 6 Beach SR, Wichman CL, Canterbury RJ. Takotsubo cardiomyopathy after electroconvulsive therapy. Psychosomatics 2010; 51: 432-436
    CrossrefPubMedGoogle Scholar
  • 7 Kellner CH, Husain MM, Knapp RG. et al. Right unilateral ultrabrief pulse ECT in geriatric depression: Phase 1 of the PRIDE study. Am J Psychiatry 2016; 173: 1101-1109
    CrossrefPubMedGoogle Scholar
  • 8 Hoyer C, Kranaster L, Janke C. et al. Impact of the anesthetic agents ketamine, etomidate, thiopental, and propofol on seizure parameters and seizure quality in electroconvulsive therapy: A retrospective study. Eur Arch Psychiatry Clin Neurosci 2014; 264: 255-261
    CrossrefPubMedGoogle Scholar
  • 9 Kranaster L, Kammerer-Ciernioch J, Hoyer C. et al. Clinically favourable effects of ketamine as an anaesthetic for electroconvulsive therapy: A retrospective study. Eur Arch Psychiatry Clin Neurosci 2011; 261: 575-582
    CrossrefPubMedGoogle Scholar
  • 10 Duma A, Pal S, Johnston J. et al. High-sensitivity cardiac troponin elevation after electroconvulsive therapy: A prospective, observational cohort study. Anesthesiology 2017; 126: 643-652
    CrossrefPubMedGoogle Scholar
  • 11 Luchner A, Weidemann A, Willenbrock R. et al. Improvement of the cardiac marker N-terminal-pro brain natriuretic peptide through adjustment for renal function: A stratified multicenter trial. Clin Chem Lab Med 2010; 48: 121-128
    PubMedGoogle Scholar
  • 12 Ponikowski P, Voors AA, Anker SD. et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal 2016; 37: 2129-2200
    CrossrefPubMedGoogle Scholar
  • 13 Landesberg G, London MJ. The enigma of postoperative troponin elevation. Anesth Analg 2016; 123: 5-7
    PubMedGoogle Scholar
  • 14 Cantor WJ, Newby LK, Christenson RH. et al. Prognostic significance of elevated troponin I after percutaneous coronary intervention. J Am Coll Cardiol 2002; 39: 1738-1744
    CrossrefPubMedGoogle Scholar
  • 15 Martinez MW, Rasmussen KG, Mueller PS. et al. Troponin elevations after electroconvulsive therapy: The need for caution. The American Journal of Medicine 2011; 124: 229-234
    CrossrefPubMedGoogle Scholar
  • 16 Kim YJ, Shin YO, Lee JB. et al. The effects of running a 308 km ultra-marathon on cardiac markers. Eur J Sport Sci 2014; 14 (Suppl. 01) S92-S97
    CrossrefPubMedGoogle Scholar