Echocardiographic evaluation of myocardial strain in bipolar disorder across different phases: A comparative study with healthy controls

Abstract

This study aims to investigate the relationship between different phases of bipolar disorder (depressive, manic, and euthymic) and myocardial deformation, assessed by echocardiography, compared to healthy controls. It seeks to elucidate whether these phases of bipolar disorder are associated with different myocardial strain patterns, thus contributing to the understanding of cardiovascular implications in bipolar disorder. A cross-sectional design was employed at Dursun Odabaş Medical Centre, Psychiatry Clinic of Van Yüzüncü Yl University. The study enrolled 200 participants, divided into 4 groups: 50 in a depressive phase, 50 in a manic phase, 50 in an euthymic phase of bipolar disorder, and 50 healthy volunteers. Participants underwent detailed electrocardiographic and ECG evaluations, focusing on myocardial strain patterns and cardiac function. Statistical analyses, including ANOVA and chi-square tests, were used to compare the groups. Significant differences in global longitudinal strain (GLS) values were observed between the groups. The manic phase group exhibited the highest GLS (21.51), followed by the euthymic (20.75), depressive (20.25), and healthy control groups (19.0). The E/A ratio of the mitral valve also varied, with the manic group displaying the highest ratio (1.21). Other echocardiographic parameters such as left atria size and Ejection Fraction also differed significantly between the groups. The study concluded that the phases of bipolar disorder are associated with distinct myocardial strain patterns, as evidenced by the variation in GLS values. The findings underscore the importance of cardiac monitoring in bipolar disorder, suggesting potential cardiac risks, particularly during the manic phase. This study advocates integrated care approaches, combining psychiatric and cardiac evaluations for patients with bipolar disorder.