Protective effect of Guanxinning on antipsychotic-induced cardiac impairment in long-term hospitalized psychiatric patients

doi:10.5498/wjp.v16.i1.111840

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Psychiatry. Jan 19, 2026; 16(1): 111840
Published online Jan 19, 2026. doi: 10.5498/wjp.v16.i1.111840

Table 1 Evaluation indicators and measurement methods

Categories	Metrics	Measurement methods	Measuring frequency
ECG parameters	QT interval, QTc interval	A 12-lead ECG	Baseline, 12 months
An echocardiogram	LVEF, LVEDD, E/A ratio	Transthoracic echocardiography	Baseline, 12 months
Serum biomarkers	cTnI, BNP, NT-proBNP	Chemiluminescence immunoassay	Baseline, 12 months
Oxidative stress markers	SOD, MDA, GSH-Px	Spectrophotometry	Baseline, 12 months
Inflammatory markers	Hs-CRP, IL-6, TNF-α	ELISA	Baseline, 12 months
Metabolic measures	Fasting blood glucose, lipid profile, HbA1c	Automatic biochemical analyzer	Baseline, 12 months
Psychiatric symptoms	PANSS score	Scale assessment	Baseline, 12 months

ECG: Electrocardiography; QT: The time from the start of the Q wave to the end of the T wave; QTc: Corrected QT; LVEF: Left ventricular ejection fraction; LVEDD: Left ventricular end-diastolic diameter; E/A ratio: Early maximal ventricular filling velocity/atrial maximal ventricular filling velocity; cTnI: Cardiac troponin I; BNP: B-type natriuretic peptide; NT-proBNP: High N-terminal pro-B-type natriuretic peptide; SOD: Superoxide dismutase; MDA: Malondialdehyde; GSH-Px: Glutathione peroxidase; Hs-CRP: High-sensitivity C-reactive protein; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-alpha; HbA1c: Hemoglobin A1c; PANSS: Positive and negative syndrome score; ELISA: Enzyme linked immuno sorbent assay.

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Table 2 Baseline characteristics of the study participants, n (%)

Characteristics	Guanxinning intervention group (n = 60)	Control group (n = 60)	P values
Age (years)	42.5 ± 10.3	43.2 ± 9.8	0.703
Gender (male/female)	32/28	34/26	0.715
Duration of illness (years), mean ± SD	15.3 ± 7.2	14.8 ± 6.9	0.689
BMI (kg/m²), mean ± SD	26.4 ± 3.8	25.9 ± 4.1	0.481
Smoking	22 (36.7)	25 (41.7)	0.572
Total PANSS score, mean ± SD	52.6 ± 5.4	53.1 ± 5.2	0.602
Type of antipsychotic medication			0.934
Olanzapine	18 (30.0)	17 (28.3)
Risperidone	15 (25.0)	16 (26.7)
Aripiprazole	14 (23.3)	15 (25.0)
Other	13 (21.7)	12 (20.0)
Combined medications
Cardiovascular medications	8 (13.3)	7 (11.7)	0.785
Hypoglycemic drugs	6 (10.0)	5 (8.3)	0.752
Antidepressants	10 (16.7)	9 (15.0)	0.803

BMI: Body mass index; PANSS: Positive and negative syndrome score.

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Table 3 Baseline cardiac function and biochemical measures, mean ± SD

Measures	Guanxinning intervention group (n = 60)	Control group (n = 60)	P values
ECG parameters
QTc interval (millisecond)	462 ± 28	465 ± 30	0.572
Echocardiographic indicators
LVEF (%)	53.5 ± 4.9	53.2 ± 4.8	0.734
LVEDD (mm)	52.3 ± 3.7	52.6 ± 3.8	0.658
E/A ratio, median (interquartile spacing)	0.92 (0.81-1.05)	0.90 (0.79-1.03)	0.512
Serum biomarkers
cTnI (ng/mL), median (interquartile spacing)	0.012 (0.008-0.018)	0.013 (0.009-0.019)	0.628
BNP (pg/mL), median (interquartile spacing)	68 (45-95)	72 (48-98)	0.453
NT-proBNP (pg/mL), median (interquartile spacing)	125 (85-180)	132 (90-185)	0.389
Indicators of oxidative stress
SOD (U/mL)	85.3 ± 12.6	83.9 ± 13.1	0.545
MDA (nmol/mL)	4.8 ± 1.2	5.0 ± 1.3	0.371
GSH-Px (U/L)	168.5 ± 22.4	165.8 ± 23.1	0.512
Inflammatory markers
Hs-CRP (mg/L), median (interquartile spacing)	2.8 (1.5-4.6)	3.0 (1.7-4.8)	0.415
IL-6 (pg/mL), median (interquartile spacing)	3.2 (2.1-4.8)	3.4 (2.3-5.0)	0.378
TNF-α (pg/mL), median (interquartile spacing)	8.5 (6.2-11.3)	8.8 (6.5-11.6)	0.462
Metabolic indices
Fasting blood glucose (mmol/L)	5.6 ± 0.8	5.5 ± 0.7	0.457
Total cholesterol (mmol/L)	4.9 ± 0.9	5.0 ± 1.0	0.554
Triglycerides (mmol/L), median (interquartile spacing)	1.8 (1.3-2.4)	1.9 (1.4-2.5)	0.389
HbA1c (%)	5.8 ± 0.6	5.7 ± 0.5	0.312

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Table 4 Between-group comparisons of main indicators after 12 months of intervention, mean ± SD

Measures	Guanxinning intervention group (n = 60)	Control group (n = 60)	P values
ECG parameters
QTc interphase (millisecond)	438 ± 25	465 ± 30	< 0.01
Echocardiographic indicators
LVEF (%)	58.5 ± 5.2	53.8 ± 4.8	< 0.05
LVEDD (mm)	49.8 ± 3.5	52.6 ± 3.8	< 0.05
E/A ratio, median (interquartile spacing)	1.05 (0.92-1.18)	0.93 (0.81-1.06)	0.002^a
Serum biomarkers
cTnI (ng/mL), median (interquartile spacing)	0.009 (0.006-0.013)	0.014 (0.010-0.020)	< 0.001^a
BNP (pg/mL), median (interquartile spacing)	52 (35-75)	78 (55-105)	< 0.001^a
NT-proBNP (pg/mL), median (interquartile spacing)	95 (65-140)	145 (100-200)	< 0.001^a

^aP < 0.01.

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Table 5 Between-group comparisons of secondary outcomes after 12 months of intervention, mean ± SD

Measures	Guanxinning intervention group (n = 60)	Control group (n = 60)	P values
Indicators of oxidative stress
SOD (U/mL)	98.6 ± 14.2	85.7 ± 13.5	< 0.001
MDA (nmol/mL)	3.9 ± 1.0	4.8 ± 1.2	< 0.001
GSH-Px (U/L)	185.3 ± 24.6	168.2 ± 23.8	< 0.001
Inflammatory markers
Hs-CRP (mg/L), median (interquartile spacing)	2.0 (1.1-3.2)	3.2 (1.9-5.0)	< 0.001^a
IL-6 (pg/mL), median (interquartile spacing)	2.5 (1.7-3.6)	3.6 (2.5-5.2)	< 0.001^a
TNF-α (pg/mL), median (interquartile spacing)	6.8 (5.0-9.1)	9.0 (6.8-11.9)	< 0.001^a
Metabolic indices
Fasting blood glucose (mmol/L)	5.3 ± 0.6	5.6 ± 0.7	0.004
Total cholesterol (tendency/L)	4.6 ± 0.8	5.1 ± 0.9	0.001
Triglycerides (tendency/L), median (interquartile spacing)	1.6 (1.2-2.1)	2.0 (1.5-2.6)	0.002^a
HbA1c (%)	5.6 ± 0.5	5.8 ± 0.5	0.045

^aP < 0.01.

SOD: Superoxide dismutase; MDA: Malondialdehyde; GSH-Px: Glutathione peroxidase; Hs-CRP: High-sensitivity C-reactive protein; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-alpha; HbA1c: Hemoglobin A1c.

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Table 6 Comparison of left ventricular ejection fraction, corrected QT, and B-type natriuretic peptideindicators before and after treatment between the intervention group and the control group

Indicators	Groups	Baseline	12 months	Time effect	Group effect	Interaction effect
LVEF (%)	Guanxinning intervention group	53.5 ± 4.9	58.5 ± 5.2	F = 45.3	F = 38.6	F = 32.1
LVEF (%)	Control group	53.2 ± 4.8	53.8 ± 4.9	P < 0.001	P < 0.001	P < 0.001
QTc interval (millisecond)	Guanxinning intervention group	462 ± 28	438 ± 25	F = 39.7	F = 42.8	F = 35.9
QTc interval (millisecond)	Control group	465 ± 30	462 ± 28	P < 0.001	P < 0.001	P < 0.001
BNP (pg/mL), median (interquartile range)	Guanxinning intervention group	68 (45-95)	52 (35-75)	-	-	-
BNP (pg/mL), median (interquartile range)	Control group	72 (48-98)	78 (55-105)	-	-	-

LVEF: Left ventricular ejection fraction; QTc: Corrected QT; BNP: B-type natriuretic peptide.

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Table 7 Friedman test results (within group comparison)

Group	χ² value	P value
Guanxinning intervention group	187.5	< 0.001
Control group	24.3	< 0.001

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Table 8 Mann-Whitney U test (between group comparison)

Time points	Z value	P value
Baseline	-0.75	0.453
12 months	-6.87	< 0.001

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Citation: Luo FG, Xing HY, Wang JJ, Wu WY, Fang KJ, Song HD, Yan J. Protective effect of Guanxinning on antipsychotic-induced cardiac impairment in long-term hospitalized psychiatric patients. World J Psychiatry 2026; 16(1): 111840
URL: https://www.wjgnet.com/2220-3206/full/v16/i1/111840.htm
DOI: https://dx.doi.org/10.5498/wjp.v16.i1.111840