Refisch Alexander, Schumann Andy, Gupta Yubraj, Schulz Steffen, Voss Andreas, Malchow Berend, Bär Karl-Jürgen
Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, 07743, Jena, Germany.
Schizophrenia (Heidelb). 2025 Mar 8;11(1):40. doi: 10.1038/s41537-025-00589-y.
Underlying biological mechanisms leading to the dramatically increased cardiac mortality in patients with schizophrenia (SCZ) are largely unknown. Cardiac autonomic dysfunction (CADF), which has been extensively described in patients with SCZ, represents an important physiological link to cardiovascular disease (CVD). This study investigated the prevalence of CADF in patients with SCZ using HRV across multiple domains (time and frequency, nonlinear dynamics, complexity measures, symbolic dynamics, and segmented Poincaré plot analysis). HRV-based clustering classified 119 SCZ patients as having or not having CADF based on deviations from 119 age- and sex-matched healthy controls. Our findings showed that approximately half of the patients had normal cardiac autonomic function, while the other half had significant abnormalities. The severity of CADF correlated with age, body mass indes (BMI), disease duration, and symptom severity. About half of SCZ patients have significant CADF, which increases their risk for cardiac events. These findings highlight the potential of HRV-based biomarkers in improving CVD risk prediction and stratification in SCZ. Future research should explore integrating HRV analysis with other biomarkers to enhance early detection and intervention strategies.
导致精神分裂症（SCZ）患者心脏死亡率大幅上升的潜在生物学机制在很大程度上尚不清楚。心脏自主神经功能障碍（CADF）在SCZ患者中已有广泛描述，是与心血管疾病（CVD）的重要生理联系。本研究使用多领域（时间和频率、非线性动力学、复杂性测量、符号动力学和分段庞加莱图分析）的心率变异性（HRV）调查了SCZ患者中CADF的患病率。基于HRV的聚类根据与119名年龄和性别匹配的健康对照的偏差，将119名SCZ患者分类为患有或未患有CADF。我们的研究结果表明，大约一半的患者心脏自主神经功能正常，而另一半则有明显异常。CADF的严重程度与年龄、体重指数（BMI）、病程和症状严重程度相关。约一半的SCZ患者有明显的CADF，这增加了他们发生心脏事件的风险。这些发现突出了基于HRV的生物标志物在改善SCZ患者CVD风险预测和分层方面的潜力。未来的研究应探索将HRV分析与其他生物标志物相结合，以加强早期检测和干预策略。
