Patients with schizophrenia exhibit a higher cardiovascular mortality compared to the general population which has been attributed to life-style factors, genetic susceptibility and antipsychotic medication. Recent echocardiographic studies have pointed to an association between clozapine treatment and reduced left ventricular ejection fraction (LVEF), a measure that has been inversely associated with adverse outcomes including all-cause mortality. Cardiovascular magnetic resonance (CMR) is considered the reference method for LVEF measurement. The aim of the present study was to investigate the LVEF in patients with schizophrenia on long-term treatment with antipsychotics and healthy controls. Twenty-nine adult patients with schizophrenia on long-term medication with antipsychotics and 27 age-, sex- and body mass index-matched healthy controls (mean ages 44 and 45 years, respectively) were recruited from outpatient psychiatric clinics in Uppsala, Sweden. The participants were interviewed and underwent physical examination, biochemical analyses, electrocardiogram and CMR. Men with schizophrenia on long-term antipsychotic treatment showed significantly lower LVEF than controls (p = 0.0076), whereas no such difference was evident among women (p = 0.44). Specifically, clozapine-treated male patients had 10.6% lower LVEF than male controls (p = 0.0064), whereas the LVEF was 5.5% below that of controls among male patients treated with non-clozapine antipsychotics (p = 0.047). Among medicated men with schizophrenia, we found significantly lower LVEF compared to healthy individuals, suggesting the need of routine cardiac monitoring in this patient group. This is the first study showing a significant negative association between treatment with non-clozapine antipsychotics and LVEF.

中文翻译：

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长期抗精神病药治疗精神分裂症男性和女性的心脏左心室射血分数

与一般人群相比，精神分裂症患者表现出更高的心血管死亡率，这归因于生活方式因素、遗传易感性和抗精神病药物。最近的超声心动图研究表明，氯氮平治疗与左心室射血分数 (LVEF) 降低之间存在关联，该指标与包括全因死亡率在内的不良结局呈负相关。心血管磁共振 (CMR) 被认为是 LVEF 测量的参考方法。本研究的目的是调查长期服用抗精神病药和健康对照的精神分裂症患者的 LVEF。29 名长期服用抗精神病药的精神分裂症成年患者，年龄 27，从瑞典乌普萨拉的精神科门诊招募性别和体重指数匹配的健康对照（平均年龄分别为 44 岁和 45 岁）。参与者接受了采访并接受了身体检查、生化分析、心电图和 CMR。接受长期抗精神病药物治疗的精神分裂症男性的 LVEF 显着低于对照组（p = 0.0076），而女性之间没有明显差异（p = 0.44）。具体而言，接受氯氮平治疗的男性患者的 LVEF 比男性对照组低 10.6% (p = 0.0064)，而接受非氯氮平抗精神病药物治疗的男性患者的 LVEF 比对照组低 5.5% (p = 0.047)。在精神分裂症患者的药物治疗中，我们发现与健康个体相比，LVEF 显着降低，表明需要在该患者组中进行常规心脏监测。这是第一项显示非氯氮平抗精神病药物治疗与 LVEF 之间存在显着负相关的研究。