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Association of age and cardiometabolic risk factors with cardiac diastolic function change in patients with bipolar

Cheng-Yi Hsiao1, Yen-Kuang Lin2, Hsin-Yi Lai3

  • 1Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan; School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.

Journal of Affective Disorders
|May 26, 2026
PubMed

Insights

Patients with bipolar disorder (BD) show poorer cardiac diastolic function. Cardiometabolic risk factors like age and insulin resistance worsen this, while lithium may improve it.

Area of Science:

  • Cardiology
  • Psychiatry
  • Echocardiography

Background:

  • Asymptomatic diastolic dysfunction is linked to heart failure and reduced survival.
  • Limited research exists on cardiac diastolic function in bipolar disorder (BD) patients.
  • Risk factors for diastolic dysfunction in BD remain under-investigated.

Purpose of the Study:

  • To evaluate cardiac diastolic function in patients with bipolar disorder (BD).
  • To identify risk factors associated with asymptomatic diastolic dysfunction in BD.
  • To compare diastolic function between BD patients and healthy controls.

Main Methods:

  • 127 individuals (65 BD, 62 controls) under 45 without heart failure diagnosis were recruited.
  • Conventional and speckle-tracking echocardiography were performed.
  • Cardiometabolic risk factors were assessed via standard in-hospital examinations.

Main Results:

  • BD patients exhibited significantly lower E velocity, septal e' velocity, average e' velocity, and E/A ratio compared to controls.
  • Left atrial conduit strain was significantly higher (indicating greater impairment) in the BD group.
  • Age, diastolic blood pressure, insulin resistance, and BMI were associated with poorer diastolic function in BD; lithium use was linked to better diastolic function and lower left ventricular mass index.

Conclusions:

  • Poorer diastolic function in BD is associated with increased age and cardiometabolic risk factors.
  • Proactive cardiometabolic interventions should be integrated into mental health care for BD patients.
  • Findings highlight the cardiac implications of BD and the need for comprehensive management.
Abstract

Keywords:
Bipolar disorderCardiac diastolic functionCardiometabolic risk factorsDoppler imagingLeft atrial strainSpeckle-tracking echocardiography

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