Key clinical point: Patients with schizophrenia may experience a significant reduction in biventricular volume and increase in concentric cardiac remodeling in the absence of established metabolic or medical comorbidities.

Major finding: Patients with schizophrenia vs. healthy individuals had a significant reduction in indexed left ventricular (LV) end-diastolic volume (effect size [d] = –0.82; P = .001), LV end-systolic volume (d = –0.58; P = .02), LV stroke volume (d = –0.85; P = .001), right ventricular (RV) end-diastolic volume (d = –0.79; P = .002), RV end-systolic volume (d = –0.58; P = .02), and RV stroke volume (d = –0.87; P = .001). There was a significant increase in LV concentricity (d = 0.73; P = .003) and septal thickness (d = 1.13; P less than .001) in patients with schizophrenia vs. matched healthy individuals.

Study details: This study assessed cardiac structure and function of 40 patients with schizophrenia and 39 matched healthy individuals using cardiac magnetic resonance imaging.

Disclosures: The study was supported by grants from the British Medical Association; the Medical Research Council, UK; the National Institute for Health Research; and British Heart Foundation. Stuart A Cook is a co-founder and director of Enleofen Bio. Declan P O’Regan and Oliver D Howes reported ties with one or more pharmaceutical companies. The remaining authors declared no conflicts of interest.

Commentary

“Cardiovascular disease causes extensive burden among people with schizophrenia, substantially contributing to the fact that those with schizophrenia lose 1-2 decades of life vs. the general population. This study examined whether cardiac structure and function is altered in people with schizophrenia using cardiac magnetic resonance imaging (CMR) the gold standard in vivo measure of cardiac structural and functional assessment. Strengths of the design are that it enrolled individuals without known metabolic or medical comorbidities and controlled for determinants of cardiovascular structure and function. A key implication of the findings is that the cardiac changes found appear to be independent of the increased prevalence of conventional cardiovascular risk factors, such as smoking, associated with schizophrenia. Findings also support the possibility that low-grade systemic inflammation or other whole-body processes could underpin the pathology of schizophrenia.”

Martha Sajatovic, MD

Professor of Psychiatry and of Neurology

Willard Brown Chair in Neurological Outcomes Research

Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center

Case Western Reserve University School of Medicine