Cardiac Dysfunction in People with Schizophrenia: Linking Clinical Outcome, the Heart, and the Brain

Abstract

While cardiovascular disease remains the primary cause of mortality in people with schizophrenia, the link between cardiac dysfunction and clinical outcome remains poorly understood. The current study is an exploratory analysis, where a total of thirteen participants with schizophrenia were included to examine clinical outcome, cardiac structure and function, and brain volume of the anterior cingulate cortex (ACC) as measured by magnetic resonance imaging, where those participants achieving remission (N = 7) had better global functioning, with fewer positive and negative symptoms on PANSS and SNS. Cardiac function and structure did not differ between remitted and non-remitted groups; but, those not in remission had significantly less volume in the left ACC. As a whole sample, no significant relationships were found between ACC volume and clinical symptoms; however, inverse relationships between social withdrawal and left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricle stroke volume (LVSV), left-ventricular concentricity (a ratio of left ventricular EDV/mass), and right ventricular end systolic volume (RVESV) were observed. Moreover, bilateral ACC volume was significantly correlated with higher LVEDV, LVSV, RVSV, and lower LV Concentricity, whereas only the left ACC was significantly related to higher RVEDV. Of note, all participants had significantly increased left ventricular concentricity compared to the general population. These results support that clinical outcome is indeed related to brain volume but may not be related to cardiac measures of function and structure in people with schizophrenia, but more research is required to verify these conclusions and to further explore the mechanisms of cardiac dysfunction.

The biological activities of vitamin A acetate and vitamin A palmitate: experiments with chickens.

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