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

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.