Chen Xue-Shi, Song Zi-Yan, Chen Xuan-Long, Bo Yi-Ming, Li Li-Liang
Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
World J Psychiatry. 2024 Dec 19;14(12):1988-1991. doi: 10.5498/wjp.v14.i12.1988.
Psychiatric disorders and heart abnormality are closely interconnected. Previous knowledge has been well-established that psychiatric disorders can lead to increased cardiovascular morbidity and even sudden cardiac death. Conversely, whether heart abnormality contributes to psychiatric disorders remains rarely studied. The work by Zhang pointed out that chronic heart failure had effects on the anxiety and depression (AD) severity, and indices including left ventricular ejection fraction, N-terminal pro-brain natriuretic peptide and interleukin-6 were independent risk factors for AD severity. In addition to the aforementioned AD, we herein find that heart failure might additionally impact the development of autism spectrum disorder and post-traumatic stress disorder (albeit > 0.05), and significantly protects against the presence of attention deficit hyperactivity disorder (ADHD), [odds ratio (OR) = 0.61, = 0.0071] by using a Mendelian randomization analysis. Bradycardia is also a protective factor for ADHD (OR = 0.61, = 0.0095), whereas hypertrophic cardiomyopathy is a mild risk factor for schizophrenia (OR = 1.02, = 0.032). These data suggest a wide spectrum of psychiatric disorders secondary to heart abnormality, and we highlight more psychiatric care that should be paid to patients with heart abnormality.
精神疾病与心脏异常密切相关。先前的知识已经明确，精神疾病会导致心血管疾病发病率增加，甚至心源性猝死。相反，心脏异常是否会导致精神疾病仍鲜有研究。Zhang的研究指出，慢性心力衰竭会影响焦虑和抑郁（AD）的严重程度，包括左心室射血分数、N末端脑钠肽前体和白细胞介素-6在内的指标是AD严重程度的独立危险因素。除了上述的AD，我们在此发现心力衰竭可能还会影响自闭症谱系障碍和创伤后应激障碍的发展（尽管P>0.05），并且通过孟德尔随机化分析显著预防注意力缺陷多动障碍（ADHD）的出现[比值比（OR）=0.61，P=0.0071]。心动过缓也是ADHD的保护因素（OR = 0.61，P = 0.0095），而肥厚型心肌病是精神分裂症的轻度危险因素（OR = 1.02，P = 0.032）。这些数据表明心脏异常会引发广泛的精神疾病，我们强调应该给予心脏异常患者更多的精神护理。
