Wang Jun, Liu Yan-song, Zhu Wen-xian, Zhang Fu-quan, Zhou Zhen-he
Department of Clinical Psychiatry, Wuxi Mental Health Center affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.
Department of Clinical Psychology, Wuxi Mental Health Center affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.
Sci Rep. 2014 Dec 9;4:7394. doi: 10.1038/srep07394.
Patients with schizophrenia have a higher risk for cardiovascular disease (CVD) than the general population. Research has suggested that autonomic imbalance is a common pathway to increased morbidity and mortality for CVD. Heart rate variability (HRV) analysis is a non-invasive method that assesses autonomic imbalance, and low HRV is correlated with high cardiovascular risk. Olanzapine, a widely used antipsychotic drug, is considered to have good cardiac safety because of not causing significant corrected QT-interval (QTc) prolongation; however, it is still unclear whether olanzapine affects HRV. We recruited 83 patients with schizophrenia who were medication-free for at least 1 month and tested their HRV at the baseline and 4 weeks after treatment with olanzapine. We found that patients who had substantial weight gain (EWG) manifested significantly lower HRV than those who had non-substantial weight gain (NWG) and that HRV decrease was positively correlated to an increase in body mass index (BMI) and weight gain. Our results indicate that olanzapine-induced weight gain may play an important role in its potential cardiovascular risk. Since olanzapine has a very high potential for weight gain compared with other antipsychotics, further research is needed to explore its cardiovascular safety profile, specifically long-term cardiac safety.
精神分裂症患者患心血管疾病（CVD）的风险高于普通人群。研究表明，自主神经失衡是CVD发病率和死亡率增加的常见途径。心率变异性（HRV）分析是一种评估自主神经失衡的非侵入性方法，低HRV与高心血管风险相关。奥氮平是一种广泛使用的抗精神病药物，由于不会导致显著的校正QT间期（QTc）延长，被认为具有良好的心脏安全性；然而，奥氮平是否会影响HRV仍不清楚。我们招募了83名至少1个月未服用药物的精神分裂症患者，并在基线和奥氮平治疗4周后测试了他们的HRV。我们发现，体重显著增加（EWG）的患者表现出的HRV明显低于体重未显著增加（NWG）的患者，并且HRV降低与体重指数（BMI）增加和体重增加呈正相关。我们的结果表明，奥氮平引起的体重增加可能在其潜在的心血管风险中起重要作用。由于与其他抗精神病药物相比，奥氮平有很高的体重增加可能性，因此需要进一步研究以探索其心血管安全性，特别是长期心脏安全性。
