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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
Protective effect of Guanxinning on antipsychotic-induced cardiac impairment in long-term hospitalized psychiatric patients
Fu-Gang Luo, Hao-Yu Xing, Jun-Jie Wang, Wen-Ye Wu, Kai-Jie Fang, Hai-Dong Song, Juan Yan
Fu-Gang Luo, Intensive Care Unit, Mental Health Center Affiliated to Zhejiang University School of Medicine/Hangzhou Seventh People’s Hospital, Hangzhou 310013, Zhejiang Province, China
Hao-Yu Xing, Department of Medical Engineering, The Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China
Jun-Jie Wang, Judicial Appraisal Institute, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China
Wen-Ye Wu, Kai-Jie Fang, Juan Yan, Quality Control Office, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China
Hai-Dong Song, Department of Medical Affairs, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China
Hai-Dong Song, The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 311402, Zhejiang Province, China
Juan Yan, Graduate School, Zhejiang Chinese Medical University, Hangzhou 311402, Zhejiang Province, China
Co-first authors: Fu-Gang Luo and Hao-Yu Xing.
Author contributions: Luo FG and Xing HY contributed equally to this article, they are the co-first authors of this manuscript; Luo FG and Yan J handled conceptualization; Luo FG and Fang KJ managed data curation; Xing HY took charge of formal analysis and validation; Wang JJ and Song HD participated in investigation; Wang JJ, Wu WY, Fang KJ, and Yan J shared the responsibility of funding acquisition; for writing-related tasks; Wang JJ and Song HD engaged in writing, reviewing and editing; Wu WY and Fang KJ managed methodology; Wu WY took charge of resources; Song HD handled supervision; Yan J was responsible for writing the original draft; and all authors thoroughly reviewed and endorsed the final manuscript.
Supported by the Special Project for Supporting the Development of Biomedicine and Health Industry in Hangzhou City, No. 2022WJC123; and Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project, No. 2022ZA143.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Hangzhou Seventh People’s Hospital, No. 2022-037, No. Yan 2023-086, and No. Yan 2024-052.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Data sharing statement: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Juan Yan, MD, Professor, Quality Control Office, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, No. 305 Tianmushan Road, Xihu District, Hangzhou 310013, Zhejiang Province, China.
294162939@qq.com
Received: July 11, 2025
Revised: July 30, 2025
Accepted: October 15, 2025
Published online: January 19, 2026
Processing time: 173 Days and 22.5 Hours
BACKGROUND
Long-term antipsychotic therapy in psychiatric patients carries significant cardiovascular risks, including QT interval prolongation, myocardial injury, and functional impairment. Guanxinning, a traditional Chinese medicine formulation, has demonstrated cardioprotective potential in preclinical studies, but clinical evidence in this population remains limited.
AIM
To evaluate the cardioprotective effects of Guanxinning against antipsychotic-induced cardiac injury in long-term hospitalized psychiatric patients.
METHODS
A randomized, double-blind, placebo-controlled trial was conducted with 120 psychiatric inpatients receiving chronic antipsychotic therapy. Participants were allocated to: Intervention group: Conventional antipsychotics + Guanxinning tablets (0.38 g × 4 tablets, ter in die); Control group: Conventional antipsychotics + identical placebo; Cardiac assessments at baseline and 12 months included: Electrocardiography (corrected QT interval), echocardiography (left ventricular ejection fraction, left ventricular end-diastolic diameter), serum biomarkers (cardiac troponin I, B-type natriuretic peptide, superoxide dismutase, malondialdehyde, high-sensitivity C-reactive protein).
RESULTS
Compared to controls, the Guanxinning group showed: Electrophysiological improvement: Corrected QT shortening (438 ± 25 milliseconds vs 465 ± 30 milliseconds, P < 0.01). Functional enhancement: Left ventricular ejection fraction increase (58.5% ± 5.2% vs 53.8% ± 4.8%, P < 0.05), left ventricular end-diastolic diameter reduction (49.8 ± 3.5 mm vs 52.6 ± 3.8 mm, P < 0.05), Biochemical modulation: Reduced myocardial injury markers (cardiac troponin I: 0.009 ng/mL vs 0.014 ng/mL; B-type natriuretic peptide: 52 pg/mL vs 78 pg/mL, P < 0.001), improved oxidative stress (superoxide dismutase: ↑13.3 U/mL; malondialdehyde: ↓0.9 nmol/mL, P < 0.001), attenuated inflammation (high-sensitivity C-reactive protein: 2.0 mg/L vs 3.2 mg/L, P < 0.001).
CONCLUSION
Guanxinning significantly mitigates antipsychotic-induced cardiac injury in psychiatric patients, demonstrating: Normalization of electrophysiological parameters, Preservation of systolic/diastolic function, suppression of oxidative stress and inflammation. These findings support its clinical application as an adjunctive cardioprotective therapy, potentially through inhibition of myocardial apoptosis and antioxidant upregulation.
Core Tip: This study highlights the cardioprotective effects of Guanxinning in patients with psychiatric disorders undergoing long-term antipsychotic therapy. The intervention significantly improved cardiac function, including shortened QT intervals, reduced myocardial enzyme fluctuations, and increased left ventricular ejection fraction. Notably, Guanxinning also enhanced antioxidant capacity and reduced oxidative stress and inflammation, suggesting its potential to mitigate antipsychotic-induced cardiac damage through anti-apoptotic mechanisms. These findings support its clinical use in protecting the heart of psychiatric patients on prolonged antipsychotic treatment.
