Evaluation of left ventricular systolic and diastolic functions in bipolar patients during lithium therapy

Abstract

Background: Bipolar disorder (BD) is a chronic mental illness that is associated with substantial functional impairment, morbidity and mortality. Lithium is still considered as a first-line therapy in BD. In this study, systolic and diastolic function parameters were measured with echocardiography in BD during lithium therapy and compared to those of a control group. Methods: Thirty BD under lithium therapy and controls were included in our study. Blood samples were taken 12 hours after receiving the last dose of lithium treatment, in the meantime echocardiography were performed. Left ventricular systolic and diastolic function was assessed by conventional echocardiography and tissue Doppler imaging. Serum lithium level correlation between diastolic function parameters was measured. Results: Baseline demographic and laboratory results did not differ significantly between the groups. Left ventricular ejection fraction (LVEF) (66.7 +/- 7.1% vs 66.7 +/- 4.9%), E/A ratio (1.14 +/- 0.41 vs 1.28 +/- 0.29), and isovolumetric relaxation time (IVRT) (77.8 +/- 14.5 cm/sec vs 75.9 +/- 17.7cm/sec) measured with conventional echocardiography showed no significant difference between the two groups. Em (14.8 +/- 5.2 cm/sec vs 15 +/- 4.6 cm/sec), Am (12.7 +/- 4.0 cm/sec vs 11.1.0 +/- 2.4 cm/sec) and E/Em (5.5 +/- 1.8 vs 5.9 +/- 2.4) measured with tissue Doppler echocardiography showed no significant difference between the two groups. Serum lithium levels were not correlated with LVEF, mitral inflow E velocity, mitral inflow A velocity, E/A ratio, deceleration time (DT), IVRT, or E/Em ratio. Conclusion: Left ventricular systolic and diastolic functions were preserved in BD during lithium therapy.