Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States.
Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States; Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, United States.
Gen Hosp Psychiatry. 2018 Mar-Apr;51:36-40. doi: 10.1016/j.genhosppsych.2017.12.005. Epub 2017 Dec 19.
Individuals with bipolar disorder are at increased risk for adverse cardiovascular disease (CVD) events. This study aimed to assess endothelial function and wave reflection, a risk factor for CVD, as measured by finger plethysmography in bipolar disorder to investigate whether CVD risk was higher in bipolar disorder and altered during acute mood episodes. We hypothesized that EndoPAT would detect a lower reactive hyperemia index (RHI) and higher augmentation index (AIX) in individuals with bipolar disorder compared with controls. Second, we predicted lower RHI and higher AIX during acute mood episodes.
Reactive hyperemia index and augmentation index, measures of microvascular endothelial function and arterial pressure wave reflection respectively, were assessed using the EndoPAT 2000 device in a sample of 56 participants with a DSM-IV diagnosis of bipolar I disorder with 82 measures spanning different mood states (mania, depression, euthymia) and cross-sectionally in 26 healthy controls.
RHI and AIX were not different between adults with and without bipolar disorder (mean age 40.3 vs. 41.2years; RHI: 2.04±0.67 vs. 2.05±0.51; AIX@75 (AIX adjusted for heart rate of 75): 1.4±19.7 vs. 0.8±22.4). When modeled in linear mixed models with a random intercept (to account for repeated observations of persons with bipolar disorder) and adjusting for age and sex, there were no significant differences between those with bipolar disorder and controls (p=0.89 for RHI; p=0.85 for AIX@75).
Microvascular endothelial function and wave reflection estimated by finger plethysmography were unable to detect differences between adults with and without bipolar disorder or changes with mood states. Future research is necessary to identify more proximal and sensitive, yet relevant, biomarkers of abnormal mood-related influences on CVD risk or must target higher risk samples.
双相情感障碍患者发生不良心血管疾病（CVD）事件的风险增加。本研究旨在通过手指容积描记法评估双相情感障碍患者的内皮功能和波反射（CVD 的一个危险因素），以探讨双相情感障碍患者的 CVD 风险是否更高，以及在急性情绪发作期间是否发生改变。我们假设与对照组相比，双相情感障碍患者的 EndoPAT 会检测到较低的反应性充血指数（RHI）和较高的增强指数（AIX）。其次，我们预测在急性情绪发作期间，RHI 会降低，AIX 会升高。
使用 EndoPAT 2000 设备评估 56 名符合 DSM-IV 诊断的双相 I 障碍患者的反应性充血指数和增强指数，这些患者跨越不同的情绪状态（躁狂、抑郁、轻躁狂）进行了 82 次测量，并在 26 名健康对照者中进行了横断面研究。
双相情感障碍患者与非双相情感障碍患者的 RHI 和 AIX 无差异（平均年龄 40.3 岁与 41.2 岁；RHI：2.04±0.67 与 2.05±0.51；AIX@75[根据 75 次心跳调整的 AIX]：1.4±19.7 与 0.8±22.4）。在使用线性混合模型进行建模，其中包含一个随机截距（以解释双相情感障碍患者的重复观察），并根据年龄和性别进行调整后，双相情感障碍患者与对照组之间无显著差异（RHI 时的 p=0.89；AIX@75 时的 p=0.85）。
通过手指容积描记法估计的微血管内皮功能和波反射无法检测到双相情感障碍患者与非患者之间的差异，也无法检测到与情绪状态相关的变化。未来的研究需要确定更接近、更敏感但相关的生物标志物，以了解异常情绪对 CVD 风险的影响，或者必须针对高风险样本进行研究。
