Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
PLoS One. 2012;7(2):e30480. doi: 10.1371/journal.pone.0030480. Epub 2012 Feb 17.
Serotonin and the serotonin transporter have been implicated in the development of pulmonary hypertension (PH). Selective serotonin reuptake inhibitors (SSRIs) may have a role in PH treatment, but the effects of SSRI use on right ventricular (RV) structure and function are unknown. We hypothesized that SSRI use would be associated with RV morphology in a large cohort without cardiovascular disease (N = 4114).
SSRI use was determined by medication inventory during the Multi-Ethnic Study of Atherosclerosis baseline examination. RV measures were assessed via cardiac magnetic resonance imaging. The cross-sectional relationship between SSRI use and each RV measure was assessed using multivariable linear regression; analyses for RV mass and end-diastolic volume (RVEDV) were stratified by sex.
After adjustment for multiple covariates including depression and left ventricular measures, SSRI use was associated with larger RV stroke volume (RVSV) (2.75 mL, 95% confidence interval [CI] 0.48-5.02 mL, p = 0.02). Among men only, SSRI use was associated with greater RV mass (1.08 g, 95% CI 0.19-1.97 g, p = 0.02) and larger RVEDV (7.71 mL, 95% 3.02-12.40 mL, p = 0.001). SSRI use may have been associated with larger RVEDV among women and larger RV end-systolic volume in both sexes.
SSRI use was associated with higher RVSV in cardiovascular disease-free individuals and, among men, greater RV mass and larger RVEDV. The effects of SSRI use in patients with (or at risk for) RV dysfunction and the role of sex in modifying this relationship warrant further study.
血清素和血清素转运体已被牵涉到肺动脉高压（PH）的发展中。选择性 5-羟色胺再摄取抑制剂（SSRIs）可能在 PH 治疗中发挥作用，但 SSRIs 使用对右心室（RV）结构和功能的影响尚不清楚。我们假设，在没有心血管疾病的大队列中（N=4114），SSRIs 的使用与 RV 形态有关。
在动脉粥样硬化多民族研究基线检查期间，通过药物清单确定 SSRIs 的使用情况。通过心脏磁共振成像评估 RV 指标。使用多变量线性回归评估 SSRIs 使用与每个 RV 指标之间的横断面关系；对 RV 质量和舒张末期容积（RVEDV）的分析按性别分层。
在调整了包括抑郁和左心室指标在内的多个协变量后，SSRIs 的使用与更大的 RV 每搏量（RVSV）相关（2.75mL，95%置信区间[CI]0.48-5.02mL，p=0.02）。仅在男性中，SSRIs 的使用与更大的 RV 质量（1.08g，95%CI0.19-1.97g，p=0.02）和更大的 RVEDV（7.71mL，95%CI3.02-12.40mL，p=0.001）相关。SSRIs 的使用可能与女性的更大的 RVEDV 和两性的更大的 RV 收缩末期容积相关。
SSRIs 的使用与无心血管疾病个体中的 RVSV 升高有关，并且在男性中，与更大的 RV 质量和更大的 RVEDV 相关。SSRIs 在 RV 功能障碍患者（或有 RV 功能障碍风险的患者）中的使用效果以及性别在改变这种关系中的作用值得进一步研究。
