Cardiovascular autonomic reflex tests using a handheld device in the diagnosis of cardiovascular autonomic neuropathy in patients with schizophrenia

Laura Blok-Husum*, Milka Ane Rank Brcelic, Hanin Kawa Farman Kawal Bassi, Svend Eggert Jensen, Rene Ernst Nielsen, Kristian Kragholm, Jesper Fleischer, Esben Laugesen, Christoffer Polcwiartek


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Study objective
This study investigated whether schizophrenia and the duration of schizophrenia were associated with cardiovascular autonomic neuropathy (CAN) by using heart rate variability (HRV) as a marker.

Cross-sectional study.

The examinations were conducted at the Centre for Psychosis Research and at the Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.

240 patients with first-episode and chronic schizophrenia and 180 controls.

CAN was assessed by the cardiovascular reflex tests (CARTs): HR, RS ratio, E:I ratio, and VM using a handheld device.

Main outcome measures
One abnormal CART was interpreted as borderline CAN and ≥2 abnormal CARTs established definitive CAN. Borderline CAN and definitive CAN together was categorized as overall CAN. Analyses were adjusted for age, sex, smoking, overweight, and hypercholesterolemia.

A total of 240 patients with schizophrenia (median age 42.5 [28.8, 52.3], 42.9 % women) and 180 controls (median age 45.8 [24.0, 60.1], 47.8 % women) were included, with 50.8 % of patients with schizophrenia having overall CAN compared to 27.2 % among controls. Dividing patients into patients with first-episode and chronic schizophrenia, 32.9 % vs 10 % (p < 0.001) and 59.1 % vs 41 % (p < 0.001) had overall CAN compared with controls, respectively. Schizophrenia was significantly associated with overall CAN (OR, 2.80; 95%CI, 1.75–4.50), with an OR of 2.31 (95%CI, 1.14–4.68) for first-episode schizophrenia and an OR of 2.97 (95%CI, 1.81–4.87) for chronic schizophrenia.

It was demonstrated that a diagnosis of schizophrenia was associated with CAN. Patients with chronic schizophrenia had a significantly higher prevalence of CAN compared to patients with first-episode schizophrenia, suggesting an association between the duration of schizophrenia and CAN.
TidsskriftAmerican Heart Journal Plus: Cardiology Research and Practice
StatusUdgivet - feb. 2023

Bibliografisk note

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© 2023 The Authors


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