Original Article

Influence of an age factor on the pathomorphology of a heart at the antipsychotic cardiomyopathy

Vladimir P. Volkov
Tver center of judicial examinations, Tver, Russia

Worldwide Medicine 2019; 1(2): 45-52 | DOI: 10.5455/ww.302644222      PDF


Abstract


Background: Currently, the life expectancy of mental patients has increased significantly, which is accompanied by an increase in the duration of antipsychotic therapy and the time of cardiotoxic side effects of antipsychotics, which is fraught with the development of neuroleptic cardiomyopathy (NCMP). In parallel, natural ontogenetic involutional processes develop in the heart.How joint influence of these two factors is reflected in a morphologic condition of a heart – this question remains open.
Methods: The autopsy protocols of 140 patients with schizophrenia (83 men and 57 women) who died at the age under 35 years and over 55 years were analyzed. The morphometric method of a research and calculation of the Coen's coefficient (d'C) determined force of influence of an age factor on pathomorphological changes of heart at various levels of its organization at development of an antipsychotic cardiomyopathy.
Results: There is pronounced and statistically significant ontogenetic changes in four of the six organometric parameters. The influence of the aging on two parameters corresponds to an average degree, on one – insignificant, and on others – small. In the presence of NCMP one indicator expressed very weakly only. The sizes d'C for all compared indicators are small and insignificant. With aging the all structural myocardial components are damaged in persons without NCMP. On the contrary, in the presence of NCMP one indicator expressed very weakly only. The sizes d'C for all indicators are small.
Conclusion: patients of different age, the crucial importance in the genesis of pathological changes of the heart at the different levels of its organization has not an age factor, but the side cardiotoxic effect of antipsychotics.
Keywords: Sedation during endoscopic procedure, Midazolam-Propofol, Ketamine-Propofol, hemodynamic effect


Keywords: Antipsychotics, cardiotoxicity, neuroleptic cardiomyopathy, pathomorphology of heart, levels of organization, morphometry, influence of age.