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Detection of subclinical atherosclerosis and diastolic dysfunction in patients with schizophrenia
Cüneyt Unsal1, Mustafa Oran, Hande Oktay Tureli
1Department of Psychiatry, Namık Kemal University, School of Medicine, Tekirdag, Turkey.
Insights
Patients with schizophrenia exhibit higher cardiovascular disease risk. Echocardiography and ABI measurements revealed subclinical disease markers, indicating an elevated risk profile in this population.
Area of Science:
- Cardiology
- Psychiatry
- Medical Imaging
Background:
- Schizophrenia patients face increased cardiovascular disease (CVD) risk and mortality.
- Early detection of subclinical CVD in schizophrenia is crucial for improving outcomes.
- Established methods like echocardiography, carotid ultrasonography, and ABI aid in CVD risk stratification.
Purpose of the Study:
- To investigate subclinical cardiovascular disease markers in schizophrenia patients.
- To compare carotid intima media thickness (CIMT) and ankle brachial index (ABI) in schizophrenia vs. controls.
- To assess conventional and tissue Doppler echocardiographic parameters in schizophrenia.
Main Methods:
- A case-control study involving 116 schizophrenia patients and 88 healthy controls.
- Exclusion criteria included comorbid psychiatric/medical conditions and specific drug use.
- Measurements included high-resolution B-mode ultrasound for CIMT and standard echocardiography protocols.
Main Results:
- Schizophrenia group showed lower ABI and specific echocardiographic patterns (e.g., E/A ratio, E', S').
- Elevated septal A' and mitral E/septal E' ratios were noted in schizophrenia patients.
- Increased carotid intima media thickness (CIMT) was observed in the schizophrenia cohort.
Conclusions:
- Doppler echocardiography parameters suggest heightened cardiovascular disease risk in schizophrenia.
- Findings support the need for proactive cardiovascular screening in schizophrenia patients.
- Subclinical CVD markers are prevalent in schizophrenia, warranting further investigation and management strategies.
Background:
Patients with schizophrenia have a higher risk for cardiovascular diseases, which is associated with early mortality compared with the nonschizophrenic population. Early diagnosis of cardiovascular diseases in asymptomatic periods in patients with schizophrenia would enhance their quality of life and reduce mortality. Echocardiography, carotid ultrasonography, and ankle brachial index (ABI) measurement are known to be beneficial methods of detecting subclinical cardiovascular diseases and of risk stratification. The present study investigated carotid intima media thickness (CIMT) and ABI and echocardiographic parameters measured via conventional and tissue Doppler echocardiography in patients with schizophrenia in comparison with a control group.
Methods:
The present case-control study included 116 patients with schizophrenia and 88 healthy patients. Participants with any current comorbid psychiatric disorder, current or lifetime neurological and medical problems, current coronary artery disease, diabetes, hypertension, hypothyroidism, or hyperthyroidism or who were using antihypertensives, antidiabetic agents, or antiobesity drugs were excluded. High-resolution B-mode ultrasound images were used to measure CIMT. Conventional and tissue Doppler measurements were performed according to the recommendations of the American Society of Echocardiography.
Results:
Low ABI, mitral ratio of the early (E) to late (A) ventricular filling velocities, septal E', septal S', lateral E', lateral S', septal E'/septal A', lateral E'/lateral A', and high septal A', mitral E/septal E', mitral E/lateral E', and CIMT values were observed in the schizophrenia group compared with the control group.
Conclusion:
Doppler parameters supported the hypothesis that patients with schizophrenia are at high risk for cardiovascular diseases.
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