Echocardiographic study of cardiac structure and function in people with bipolar disorder after midlife

Objective: Over a half century, lithium has been used as the first-line medication to treat bipolar disorder. Emerging clinical and laboratory studies suggest that lithium may exhibit cardioprotective effects in addition to neuroprotective actions. Fractalkine (CX3CL1) is a unique chemokine associated with the pathogenesis of mood disorders and cardiovascular diseases. Herein we aimed to ascertain whether lithium treatment is associated with favorable cardiac structure and function in relation to the reduced CX3CL1 among patients with bipolar disorder. Methods: We recruited 100 euthymic patients with bipolar I disorder aged over 20 years to undergo echocardiographic study and measurement of plasma CX3CL1. Associations between lithium treatment, cardiac structure and function and peripheral CX3CL1 were analyzed according to the cardiovascular risk. The high cardiovascular risk was defined as (1) age ⩾ 45 years in men or ⩾ 55 years in women or (2) presence of concurrent cardiometabolic diseases. Results: In the high cardiovascular risk group ( n = 61), patients who received lithium as the maintenance treatment had significantly lower mean values of left ventricular internal diameters at end-diastole (Cohen’s d = 0.65, p = 0.001) and end-systole (Cohen’s d = 0.60, p = 0.004), higher mean values of mitral valve E/A ratio (Cohen’s d = 0.51, p = 0.019) and superior performance of global longitudinal strain (Cohen’s d = 0.51, p = 0.037) than those without lithium treatment. In addition, mean plasma levels of CX3CL1 in the high cardiovascular risk group were significantly lower among patients with lithium therapy compared with those without lithium treatment ( p = 0.029). Multiple regression models showed that the association between lithium treatment and mitral value E/A ratio was contributed by CX3CL1. Conclusion: Data from this largest sample size study of the association between lithium treatment and echocardiographic measures suggest that lithium may protect cardiac structure and function in patients with bipolar disorder. Reduction of CX3CL1 may mediate the cardioprotective effects of lithium.

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Abstract 17334: Effects of Alcohol Consumption on Fiver-Year Change in Cardiac Structure and Function: In the Echocardiographic Study of Latinos

Circulation ◽

10.1161/circ.142.suppl_3.17334 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Cristian Zamora ◽

Un Jung Lee ◽

Mayank M Kansal ◽

Barry E Hurwitz ◽

Mario J Garcia ◽

...

Keyword(s):

Alcohol Consumption ◽

Systolic Function ◽

Left Ventricular ◽

Structure And Function ◽

Cardiac Structure ◽

Echocardiographic Study ◽

Cardiac Structure And Function ◽

Binge Drinkers ◽

And Function ◽

Rv Function

Background: The relationship between alcohol consumption and clinical heart failure has been extensively studied. There have been little longitudinal data documenting alcohol effects on cardiac structure and function in a community-based population. Methods: The second Echocardiographic Study of Latinos (ECHO-SOL2) was designed to provide echocardiographic parameters that characterized longitudinal cardiac structure and function in a random and representative sample of 1,818 participants ≥45 years old. Participants underwent to serial echocardiograms at 2011-2014 (exam 1) and ~5-6 years later at 2016-2019 (exam 2). Quantification of alcohol was created on a gender-specific basis. Multiple linear regression models were adjusted for age and sex. Results: The mean age at enrollment was 56.4 years old, 57% were women. At baseline, impaired left ventricular (LV) systolic function and increased right ventricular (RV) function were associated with binge drinkers (P = 0.01). At 5-6 years later, heavy drinkers had a significant decrease in LV ejection fraction (P = 0.01). Moderate and binge drinkers demonstrated worsening diastolic function over time (P ≤ 0.01). Binge drinkers demonstrated a progressive decrease in LV mass index (P = 0.02), decrease in LV stroke volume (P = 0.01) and further reduction in RV function (P < 0.01). Conclusion: Alcohol consumption was associated with longitudinal changes in cardiac structure and function, mostly among binge drinkers, which can lead to impaired myocardial contractility compared to nondrinkers.

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Association of Cardiac Structure and Function With Neurocognition in Hispanics/Latinos: The Echocardiographic Study of Latinos

Mayo Clinic Proceedings Innovations Quality & Outcomes ◽

10.1016/j.mayocpiqo.2018.02.003 ◽

2018 ◽

Vol 2 (2) ◽

pp. 165-175

Author(s):

Mohamed Faher Almahmoud ◽

Hector M. Gonzalez ◽

Katrina Swett ◽

Wassim Tarraf ◽

Neil Schneiderman ◽

...

Keyword(s):

Structure And Function ◽

Cardiac Structure ◽

Echocardiographic Study ◽

Cardiac Structure And Function ◽

And Function

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Association of acculturation with cardiac structure and function among Hispanics/Latinos: a cross-sectional analysis of the echocardiographic study of Latinos

BMJ Open ◽

10.1136/bmjopen-2018-028729 ◽

2019 ◽

Vol 9 (11) ◽

pp. e028729 ◽

Cited By ~ 1

Author(s):

Lenny López ◽

Katrina Swett ◽

Fátima Rodriguez ◽

Jorge R Kizer ◽

Frank Penedo ◽

...

Keyword(s):

Structure And Function ◽

Volume Index ◽

Secondary Outcome ◽

Cardiac Structure ◽

Foreign Born ◽

Cross Sectional ◽

Echocardiographic Study ◽

Echocardiographic Assessment ◽

Cardiac Structure And Function ◽

And Function

ObjectiveHispanics/Latinos, the largest immigrant population in the USA, undergo the process of acculturation and have a large burden of heart failure risk. Few studies have examined the association of acculturation on cardiac structure and function.DesignCross-sectional.SettingThe Echocardiographic Study of Latinos.Participants1818 Hispanic adult participants with baseline echocardiographic assessment and acculturation measured by the Short Acculturation Scale, nativity, age at immigration, length of US residence, generational status and language.Primary and secondary outcome measuresEchocardiographic assessment of left atrial volume index (LAVI), left ventricular mass index (LVMI), early diastolic transmitral inflow and mitral annular velocities.ResultsThe study population was predominantly Spanish-speaking and foreign-born with mean residence in the US of 22.7 years, mean age of 56.4 years; 50% had hypertension, 28% had diabetes and 44% had a body mass index >30 kg/m2. Multivariable analyses demonstrated higher LAVI with increasing years of US residence. Foreign-born and first-generation participants had higher E/e′ but lower LAVI and e′ velocities compared with the second generation. Higher acculturation and income >$20K were associated with higher LVMI, LAVI and E/e′ but lower e′ velocities. Preferential Spanish-speakers with an income <$20K had a higher E/e′.ConclusionsAcculturation was associated with abnormal cardiac structure and function, with some effect modification by socioeconomic status.

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Associations between physical activity, sedentary behaviour and left ventricular structure and function from the Echocardiographic Study of Latinos (ECHO-SOL)

Open Heart ◽

10.1136/openhrt-2021-001647 ◽

2021 ◽

Vol 8 (2) ◽

pp. e001647

Author(s):

Andrew E Berdy ◽

Bharathi Upadhya ◽

Sonia Ponce ◽

Katrina Swett ◽

Richard B Stacey ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behaviour ◽

Left Ventricular ◽

Structure And Function ◽

Volume Index ◽

Cardiac Structure ◽

Echocardiographic Study ◽

Modifiable Factors ◽

Cardiac Structure And Function ◽

And Function

ObjectiveThe cross-sectional association between accelerometer-measured physical activity (PA), sedentary behaviour (SB) and cardiac structure and function is less well described. This study’s primary aim was to compare echocardiographic measures of cardiac structure and function with accelerometer measured PA and SB.MethodsParticipants included 1206 self-identified Hispanic/Latino men and women, age 45–74 years, from the Echocardiographic Study of Latinos. Standard echocardiographic measures included M-mode, two-dimensional, spectral, tissue Doppler and myocardial strain. Participants wore an Actical accelerometer at the hip for 1 week.ResultsThe mean±SE age for the cohort was 56±0.4 years, 57% were women. Average moderate to vigorous PA (MVPA) was 21±1.1 min/day, light PA was 217±4.2 min/day and SB was 737±8.1 min/day. Both higher levels of light PA and MVPA (min/day) were associated with lower left ventricular (LV) mass index (LVMI)/end-diastolic volume and a lower E/e′ ratio. Higher levels of MVPA (min/day) were associated with better right ventricular systolic function. Higher levels of SB were associated with increased LVMI. In a multivariable linear regression model adjusted for demographics and cardiovascular disease modifiable factors, every 10 additional min/day of light PA was associated with a 0.03 mL/m2 increase in left atrial volume index (LAVI) (p<0.01) and a 0.004 cm increase in tricuspid annular plane systolic excursion (p<0.01); every 10 additional min/day of MVPA was associated with a 0.18 mL/m2 increase in LAVI (p<0.01) and a 0.24% improvement in global circumferential strain (p<0.01).ConclusionsOur findings highlight the potential positive association between the MVPA and light PA on cardiac structure and function.

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