Brian Tong1, Oluchi Abosi2, Samantha Schmitz2, Janie Myers3, Gary L Pierce4, Jess G Fiedorowicz5. 1. Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States. 2. Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States; Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, United States. 3. Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States; Department of Health and Human Physiology, College of Liberal Arts and Sciences, The University of Iowa, Iowa City, IA, United States. 4. Department of Health and Human Physiology, College of Liberal Arts and Sciences, The University of Iowa, Iowa City, IA, United States; François M. Abboud Cardiovascular Research Center, The University of Iowa, Iowa City, IA, United States; Fraternal Order of Eagles Research Center, The University of Iowa, Iowa City, IA, United States. 5. Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States; Department of Internal Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States; Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, United States; François M. Abboud Cardiovascular Research Center, The University of Iowa, Iowa City, IA, United States; Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, United States; Obesity Research and Education Initiative, The University of Iowa, Iowa City, IA, United States. Electronic address: jess-fiedorowicz@uiowa.edu.
Abstract
BACKGROUND: Individuals with bipolar disorder are at increased risk for adverse cardiovascular disease (CVD) events. This study aimed to assess endothelial function and wave reflection, a risk factor for CVD, as measured by finger plethysmography in bipolar disorder to investigate whether CVD risk was higher in bipolar disorder and altered during acute mood episodes. We hypothesized that EndoPAT would detect a lower reactive hyperemia index (RHI) and higher augmentation index (AIX) in individuals with bipolar disorder compared with controls. Second, we predicted lower RHI and higher AIX during acute mood episodes. METHODS: Reactive hyperemia index and augmentation index, measures of microvascular endothelial function and arterial pressure wave reflection respectively, were assessed using the EndoPAT 2000 device in a sample of 56 participants with a DSM-IV diagnosis of bipolar I disorder with 82 measures spanning different mood states (mania, depression, euthymia) and cross-sectionally in 26 healthy controls. RESULTS: RHI and AIX were not different between adults with and without bipolar disorder (mean age 40.3 vs. 41.2years; RHI: 2.04±0.67 vs. 2.05±0.51; AIX@75 (AIX adjusted for heart rate of 75): 1.4±19.7 vs. 0.8±22.4). When modeled in linear mixed models with a random intercept (to account for repeated observations of persons with bipolar disorder) and adjusting for age and sex, there were no significant differences between those with bipolar disorder and controls (p=0.89 for RHI; p=0.85 for AIX@75). CONCLUSIONS: Microvascular endothelial function and wave reflection estimated by finger plethysmography were unable to detect differences between adults with and without bipolar disorder or changes with mood states. Future research is necessary to identify more proximal and sensitive, yet relevant, biomarkers of abnormal mood-related influences on CVD risk or must target higher risk samples.
BACKGROUND: Individuals with bipolar disorder are at increased risk for adverse cardiovascular disease (CVD) events. This study aimed to assess endothelial function and wave reflection, a risk factor for CVD, as measured by finger plethysmography in bipolar disorder to investigate whether CVD risk was higher in bipolar disorder and altered during acute mood episodes. We hypothesized that EndoPAT would detect a lower reactive hyperemia index (RHI) and higher augmentation index (AIX) in individuals with bipolar disorder compared with controls. Second, we predicted lower RHI and higher AIX during acute mood episodes. METHODS: Reactive hyperemia index and augmentation index, measures of microvascular endothelial function and arterial pressure wave reflection respectively, were assessed using the EndoPAT 2000 device in a sample of 56 participants with a DSM-IV diagnosis of bipolar I disorder with 82 measures spanning different mood states (mania, depression, euthymia) and cross-sectionally in 26 healthy controls. RESULTS: RHI and AIX were not different between adults with and without bipolar disorder (mean age 40.3 vs. 41.2years; RHI: 2.04±0.67 vs. 2.05±0.51; AIX@75 (AIX adjusted for heart rate of 75): 1.4±19.7 vs. 0.8±22.4). When modeled in linear mixed models with a random intercept (to account for repeated observations of persons with bipolar disorder) and adjusting for age and sex, there were no significant differences between those with bipolar disorder and controls (p=0.89 for RHI; p=0.85 for AIX@75). CONCLUSIONS: Microvascular endothelial function and wave reflection estimated by finger plethysmography were unable to detect differences between adults with and without bipolar disorder or changes with mood states. Future research is necessary to identify more proximal and sensitive, yet relevant, biomarkers of abnormal mood-related influences on CVD risk or must target higher risk samples.
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