Cardioprotective potential of lithium and role of fractalkine in euthymic patients with bipolar disorder

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

Journal of Affective Disorders ◽

10.1016/j.jad.2021.09.089 ◽

2021 ◽

Author(s):

Pao-Huan Chen ◽

Shuo-Ju Chiang ◽

Cheng-Yi Hsiao ◽

Ruei-Siang Shen ◽

Yen-Kuang Lin ◽

...

Keyword(s):

Bipolar Disorder ◽

Structure And Function ◽

Cardiac Structure ◽

Echocardiographic Study ◽

Cardiac Structure And Function ◽

And Function

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Cardiac structure and function in relation to cardiovascular risk factors in Chinese

BMC Cardiovascular Disorders ◽

10.1186/1471-2261-12-86 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 3

Author(s):

Yi Zhang ◽

Yan Li ◽

Ming Liu ◽

Chang-Sheng Sheng ◽

Qi-Fang Huang ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Structure And Function ◽

Cardiac Structure ◽

Cardiac Structure And Function ◽

And Function

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The impact of cardiovascular risk factors on cardiac structure and function: Insights from the UK Biobank imaging enhancement study

PLoS ONE ◽

10.1371/journal.pone.0185114 ◽

2017 ◽

Vol 12 (10) ◽

pp. e0185114 ◽

Cited By ~ 24

Author(s):

Steffen E. Petersen ◽

Mihir M. Sanghvi ◽

Nay Aung ◽

Jackie A. Cooper ◽

José Miguel Paiva ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Structure And Function ◽

Cardiac Structure ◽

Uk Biobank ◽

Cardiac Structure And Function ◽

The Uk ◽

And Function ◽

The Impact

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Differences in Cardiac Structure and Function Between Black and White Patients: Another Step in the Evaluation of Cardiovascular Risk in Chronic Kidney Disease

American Journal of Hypertension ◽

10.1093/ajh/hpx093 ◽

2017 ◽

Vol 30 (8) ◽

pp. 770-771

Author(s):

Emilio Nardi ◽

Giuseppe Mulè ◽

Chiara Nardi ◽

Maurizio Averna

Keyword(s):

Chronic Kidney Disease ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Structure And Function ◽

Cardiac Structure ◽

Black And White ◽

Cardiac Structure And Function ◽

And Function ◽

White Patients

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Changes in cardiac structure and function with aging

10.20517/jca.2021.40 ◽

2022 ◽

Author(s):

Tanushree Agrawal ◽

Sherif F. Nagueh

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Cardiac Remodeling ◽

Structure And Function ◽

Cardiac Structure ◽

Physiological Changes ◽

Age Related ◽

Cardiac Structure And Function ◽

And Function

Aging is associated with progressive changes in cardiac structure and function. The prevalence of cardiovascular risk factors and disease also increases profoundly with advancing age. Therefore, understanding the spectrum of physiological changes in the aging heart is crucial for the identification and risk stratification of cardiovascular disease. In this review, we discuss echocardiographic features of age-related cardiac remodeling.

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Puberty timing and markers of cardiovascular structure and function at 25 years: a prospective cohort study

BMC Medicine ◽

10.1186/s12916-021-01949-y ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Gillian M. Maher ◽

Lisa Ryan ◽

Fergus P. McCarthy ◽

Alun Hughes ◽

Chloe Park ◽

...

Keyword(s):

Cohort Study ◽

Cardiovascular Risk ◽

Early Adulthood ◽

Structure And Function ◽

Height Velocity ◽

Cardiac Structure ◽

Cardiovascular Structure ◽

Males And Females ◽

Cardiac Structure And Function ◽

And Function

Abstract Background Whether earlier onset of puberty is associated with higher cardiovascular risk in early adulthood is not well understood. Our objective was to examine the association between puberty timing and markers of cardiovascular structure and function at age 25 years. Methods We conducted a prospective birth cohort study using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants were born between April 1, 1991, and December 31, 1992. Exposure of interest was age at peak height velocity (aPHV), an objective and validated growth-based measure of puberty onset. Outcome measures included cardiovascular structure and function at age 25 years: carotid intima-media thickness (CIMT), left ventricular mass index (LVMI) and relative wall thickness (RWT), pulse wave velocity (PWV) and systolic blood pressure (SBP). Multiple imputation was used to impute missing data on covariates and outcomes. Linear regression was used to examine the association between aPHV and each measure of cardiac structure and function, adjusting for maternal age, gestational age, household social class, maternal education, mother’s partner’s education, breastfeeding, parity, birthweight, maternal body mass index, maternal marital status, maternal prenatal smoking status and height and fat mass at age 9. All analyses were stratified by sex. Results A total of 2752–4571 participants were included in the imputed analyses. A 1-year older aPHV was not strongly associated with markers of cardiac structure and function in males and females at 25 years and most results spanned the null value. In adjusted analyses, a 1-year older aPHV was associated with 0.003 mm (95% confidence interval (CI) 0.00001, 0.006) and 0.0008 mm (95% CI − 0.002, 0.003) higher CIMT; 0.02 m/s (95% CI − 0.05, 0.09) and 0.02 m/s (95% CI − 0.04, 0.09) higher PWV; and 0.003 mmHg (95% CI − 0.60, 0.60) and 0.13 mmHg (95% CI − 0.44, 0.70) higher SBP, among males and females, respectively. A 1-year older aPHV was associated with − 0.55 g/m2.7 (95% CI − 0.03, − 1.08) and − 0.89 g/m2.7 (95% CI − 0.45, − 1.34) lower LVMI and − 0.001 (95% CI − 0.006, 0.002) and − 0.002 (95% CI − 0.006, 0.002) lower RWT among males and females. Conclusions Earlier puberty is unlikely to have a major impact on pre-clinical cardiovascular risk in early adulthood.

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