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双相障碍患者的血脂和炎症标志物与左心室壁厚度的关系。

Association of lipids and inflammatory markers with left ventricular wall thickness in patients with bipolar disorder.

机构信息

Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Division 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; Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

J Affect Disord. 2024 Aug 1;358:12-18. doi: 10.1016/j.jad.2024.05.020. Epub 2024 May 3.

Abstract

BACKGROUND

Individuals with bipolar disorder (BD) face a high risk of heart failure and left ventricular (LV) dysfunction. Despite strong evidence that high LV relative wall thickness (RWT) is a risk marker for heart failure, few studies have evaluated LV RWT and aggravating factors in individuals with BD.

METHODS

We recruited 104 participants (52 patients with BD and 52 age- and sex-matched mentally healthy controls) to undergo echocardiographic imaging and biochemistry, high-sensitivity C-reactive protein (hs-CRP), and blood cell count measurements. LV RWT was estimated using the following equation: (2 × LV posterior wall end-diastolic thickness)/LV end-diastolic diameter. Clinical data were obtained through interviews and chart reviews.

RESULTS

The BD group exhibited a significantly greater LV RWT (Cohen's d = 0.53, p = 0.003) and a less favorable mitral valve E/A ratio (Cohen's d = 0.54, p = 0.023) and LV global longitudinal strain (Cohen's d = 0.57, p = 0.047) than did the control group. Multiple linear regression revealed that in the BD group, serum triglyceride levels (β = 0.466, p = 0.001), platelet-to-lymphocyte ratios (β = 0.324, p = 0.022), and hs-CRP levels (β = 0.289, p = 0.043) were all significantly and positively associated with LV RWT.

LIMITATIONS

This study applied a cross-sectional design, meaning that the direction of causation could not be inferred.

CONCLUSIONS

Patients with BD are at a risk of heart failure, as indicated by their relatively high LV RWT. Lipid levels and systemic inflammation may explain this unfavorable association.

摘要

背景

双相情感障碍(BD)患者发生心力衰竭和左心室(LV)功能障碍的风险较高。尽管有强有力的证据表明,LV 相对壁厚度(RWT)较高是心力衰竭的风险标志物,但很少有研究评估 BD 患者的 LV RWT 及其加重因素。

方法

我们招募了 104 名参与者(52 名 BD 患者和 52 名年龄和性别匹配的心理健康对照者)进行超声心动图成像和生物化学、高敏 C 反应蛋白(hs-CRP)和血细胞计数测量。LV RWT 使用以下公式估计:(2×LV 后壁舒张末期厚度)/LV 舒张末期直径。通过访谈和病历回顾获取临床数据。

结果

BD 组的 LV RWT 显著更高(Cohen's d=0.53,p=0.003),二尖瓣 E/A 比值(Cohen's d=0.54,p=0.023)和 LV 整体纵向应变(Cohen's d=0.57,p=0.047)更差。多元线性回归显示,在 BD 组中,血清甘油三酯水平(β=0.466,p=0.001)、血小板与淋巴细胞比值(β=0.324,p=0.022)和 hs-CRP 水平(β=0.289,p=0.043)均与 LV RWT 呈显著正相关。

局限性

本研究采用了横断面设计,这意味着不能推断因果关系的方向。

结论

BD 患者发生心力衰竭的风险较高,这表现为他们的 LV RWT 相对较高。血脂水平和全身炎症可能解释了这种不利的关联。

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