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Antipsychotic medication influences cardiovascular coupling in patients suffering from acute schizophrenia

机译:抗精神病药会影响急性精神分裂症患者的心血管耦合

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Schizophrenia (SZO) is one of the most serious mental illnesses in the world associated with the risk for cardiovascular events. The aim of this study was to quantify and characterize how different antipsychotics influence short-term cardiovascular couplings (CVC) in acute SZO. In this study CVC of 42 unmedicated (UNMED), 42 medicated (MED) patients suffering from SZO and 42 age and gender matched healthy subjects (CON) was analyzed applying the High Resolution Joint Symbolic Dynamics. We found decreased CVC in SZO (UNMED, MED) characterized by CVC patterns that were less predominant and more distributed in comparison to CON and mainly dominated by a greater amount of slow increasing, slow decreasing, alternating and fluctuating systolic blood pressure in combination with invariable heart rate responses. The impairment of the cardiovascular system in SZO was much more formed in MED and seems to be due to the anti-cholinergic effects of antipsychotics. Especially, a subgroup of MED treated with clozapine, quetiapine and amisulpride had the strongest influence on CVC than those treaded with olanzapine. These results might contribute to an optimal selection of therapy strategies minimizing cardiovascular pro-arrhythmic effects in SZO and thus to a more individual patient adapted therapy.
机译:精神分裂症(SZO)是世界上与心血管事件风险相关的最严重的精神疾病之一。这项研究的目的是量化和表征不同的抗精神病药如何影响急性SZO中的短期心血管耦合(CVC)。在这项研究中,应用高分辨率联合符号动力学分析了42位未接受药物治疗(UNMED),42位接受SZO治疗的药物治疗(MED)患者和42位年龄和性别匹配的健康受试者(CON)的CVC。我们发现SZO(UNMED,MED)中的CVC降低,其特征是与CON相比,CVC模式的优势更小,分布更广泛,并且主要由大量的缓慢升高,缓慢降低,交替和波动的收缩压以及不变的血压共同决定心率反应。 SZO的心血管系统损害在MED中更容易形成,似乎是由于抗精神病药的抗胆碱作用所致。尤其是,用氯氮平,喹硫平和氨磺必利治疗的MED亚组对CVC的影响要比奥氮平所治疗的多。这些结果可能有助于最佳选择治疗策略,以最大程度地降低SZO中的心血管促心律失常作用,从而有助于患者适应性更强的治疗。

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