Assessment Of Left Ventricular Structure And Function Of Atypical Antipsychotics In Patients With Schizophrenia

Objects:This study aimed to assess the short-term and long-term impacts of atypical antipsychotics on left ventricular structure and function using echocardiography with two-dimensional speckle-tracking imaging in patients with schizophrenia,simultaneously combined with weight and glucolipid metabolic index and the changes of electrocardiogram,thus,it will provide indicators and evidence for cardiac damage in the daily clinics.Methods:From September 2017 to March 2019,112 patients diagnosed with schizophrenia in our hospital were enrolled.According to the treatment duration,the patients were divided into the short-term treatment(2 months)group and the long-term treatment(1 year)group.Echocardiography were performed in both groups to obtain data of cardiac structure and function.According to the different prescriptions,69 patients in the short time treatment were divided into the four groups of risperidone(20 patients),olanzapine(23 patients),ziprasidone(14 patients)and clozapine(12 patients).Also,25 normal subjects were recruited as the control group.38 patients in the long time treatment were defined as patients who took the drugs for 1 year continuously(the above four drugs can be used interchangeably,with no limit on the time of taking various drugs).Body weight and cardiac function were compared between the disease group and the control group before administration.The weight,metabolic-related indices,electrocardiogram,conventional echocardiographic data and strain parameters of the patients after the treatment were compared with those in baseline Results: 1.Assessing the impacts of short-term drug application on cardiac structure and function1)There was no statistical difference in the indices between the control group and the disease group before the treatment(P>0.05).2)Comparison of general metabolic index,body weight,fasting plasma glucose(FPG),triglycerides(TG)and total cholesterol(TC)after different prescriptions were higher than those in the baseline(P < 0.05).However in the ziprasidone group,no statistical significance in the above parameters were found between the baseline and the 2 month follow-up(P > 0.05).3)Electrocardiogram changes.The total incidence of abnormal electrocardiogram was 27.5%.There was no statistical difference inincidence of abnormal electrocardiogram among the four groups(P>0.05).4)Comparison of ultrasonic routine and strain parameters.There was no difference in left atrial diameter(LAD),left end-diastolic diameter(LVEDd),E/A,left ventricular ejection fraction(LVEF),left ventricular global longitudinal strain(GLs)and left ventricular global circumferential strain(GCs)in the four groups before and after treatment(P>0.05).2.Assessing the effects of long-term drug application on cardiac structure and function1)There was no statistical difference in the indexes or parameters between the control group and before the treatment of the disease group(P>0.05).2)Comparison of general metabolic index.Body weight,FPG,TG and TC were significantly increased(P<0.05).3)Comparison of electrocardiogram changes.The incidence of abnormal ECG was 28.9%.There was no statistical difference in the incidence of abnormal ECG beteeen short-term and long-term drug application(P>0.05).4)Comparison of ultrasonic routine and strain parameters.E/A was decreased after treatment(P<0.05).There was no significant difference in LAD,LVEDd and LVEF(P>0.05).In strain parameters,GLs was significantly decreased(P<0.05)and there was no statistical difference in GCs(P >0.05).Conclusion: 1.The short-term use of atypical antipsychotics can cause weight gain,elevated glucose and lipid in patients with schizophrenia.Atypical antipsychotics had little influence on the structure and function of the cardiac in the short term which could be used safely under the premise of regular examination of various indicators.2.There was no obvious change in patients with long-term use atypical antipsychotics in cardiac structure and left ventricular ejection.But ultrasound combined with two-dimensional speckle tracking technology has been detected the change in left ventricular diastolic function and longitudinal systolic function,and provide more comprehensive quantitative indicators for clinical measures to early intervention and prevent further cardiac damage.