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The Deceleration Capacity - a New Measure of Heart Rate Variability Evaluated in Patients With Schizophrenia and Antipsychotic Treatment

Published online by Cambridge University Press:  14 September 2011

A. Birkhofer ,
J. Geissendoerfer ,
P. Alger ,
A. Mueller ,
M. Rentrop ,
T. Strubel ,
S. Leucht ,
H. Förstl ,
K.-J. Bär  and
G. Schmidt
A. Birkhofer*
Affiliation:
Technische Universität München, Klinik für Psychiatrie und Psychotherapie, Ismaninger Str 22, 81675München, Germany
J. Geissendoerfer
Affiliation:
Technische Universität München, Klinik für Psychiatrie und Psychotherapie, Ismaninger Str 22, 81675München, Germany
P. Alger
Affiliation:
Technische Universität München, Klinik für Psychiatrie und Psychotherapie, Ismaninger Str 22, 81675München, Germany
A. Mueller
Affiliation:
Department of Medicine and Centre of Non-linear Dynamic, Technische Universität, München, Germany
M. Rentrop
Affiliation:
Technische Universität München, Klinik für Psychiatrie und Psychotherapie, Ismaninger Str 22, 81675München, Germany
T. Strubel
Affiliation:
Technische Universität München, Klinik für Psychiatrie und Psychotherapie, Ismaninger Str 22, 81675München, Germany
S. Leucht
Affiliation:
Technische Universität München, Klinik für Psychiatrie und Psychotherapie, Ismaninger Str 22, 81675München, Germany
H. Förstl
Affiliation:
Technische Universität München, Klinik für Psychiatrie und Psychotherapie, Ismaninger Str 22, 81675München, Germany
K.-J. Bär
Affiliation:
Department of Psychiatry and Psychotherapy, Ruhr-Universität, Alexandrinenstr. 1, 44791Bochum, Germany
G. Schmidt
Affiliation:
Department of Medicine and Centre of Non-linear Dynamic, Technische Universität, München, Germany
*
⁎Corresponding author. Tel.: +49 89 4140 4220; fax: +49 89 4140 4987. E-mail address: andreas.birkhofer@lrz.tum.de (A. Birkhofer).
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Abstract

Background

Schizophrenia is associated with increased cardiac mortality. A disturbed autonomic modulation of heart rate (HR) has been described in patients with schizophrenia in whom antipsychotic medication may represent an additional cardiac risk. The novel measure deceleration capacity (DC) of heart rate predicts cardiac mortality in patients with cardiovascular illnesses. The aim of the present paper was to calculate DC in patients with schizophrenia and to compare this measure with established parameters of heart rate variability (HRV).

Methods

HRV and DC were calculated in 24-hour electrocardiogram (ECG) recordings of 20 unmedicated, 40 medicated patients with schizophrenia and 40 controls. As activity has a major influence on HRV, 4-hour periods of “sleep-” and “wake-” ECG were evaluated as additional parameters. Actigraphy was used to ensure comparable levels of activity in patients and controls.

Results

The DC as well as the other established HRV measures were not significantly different comparing unmedicated patients with schizophrenia to healthy controls. However, medicated patients showed a significant reduction of DC calculated from ECG recordings during 4 hour over night periods.

Conclusion

Calculation of DC might contribute to a better monitoring and identification of an increased risk of cardiac mortality in patients with schizophrenia undergoing antipsychotic treatment.

Keywords

SchizophreniaAntipsychoticDeceleration capacityHeart rate variabilityMortality riskPsychophysiologyCardiac mortality
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 2 , February 2013 , pp. 81 - 86
Copyright
Copyright © Elsevier Masson SAS 2013

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Footnotes

Abbreviations: BDI, Beck Depression Inventory; BPRS, Brief Psychiatric Rating Scale; CGI, Clinical Global Impression Scale; DC, deceleration capacity; ESI, Eppendorf Schizophrenia Inventory; HRV, heart rate variability; PRSA, phase rectified signal averaging; RMSSD, square root of the mean squared differences of successive intervals; SDNN, standard deviation of normal to normal intervals; STAI, State-Trait-Anxiety Inventory.

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