title: Selective serotonin reuptake inhibitor use is associated with right ventricular structure and function: the MESA-right ventricle study.
abstract: OBJECTIVE
  Serotonin and the serotonin transporter have been implicated in the development of pulmonary hypertension (PH). Selective serotonin reuptake inhibitors (SSRIs) may have a role in PH treatment, but the effects of SSRI use on right ventricular (RV) structure and function are unknown. We hypothesized that SSRI use would be associated with RV morphology in a large cohort without cardiovascular disease (N = 4114).
  
  
  METHODS
  SSRI use was determined by medication inventory during the Multi-Ethnic Study of Atherosclerosis baseline examination. RV measures were assessed via cardiac magnetic resonance imaging. The cross-sectional relationship between SSRI use and each RV measure was assessed using multivariable linear regression; analyses for RV mass and end-diastolic volume (RVEDV) were stratified by sex.
  
  
  RESULTS
  After adjustment for multiple covariates including depression and left ventricular measures, SSRI use was associated with larger RV stroke volume (RVSV) (2.75 mL, 95% confidence interval [CI] 0.48-5.02 mL, p = 0.02). Among men only, SSRI use was associated with greater RV mass (1.08 g, 95% CI 0.19-1.97 g, p = 0.02) and larger RVEDV (7.71 mL, 95% 3.02-12.40 mL, p = 0.001). SSRI use may have been associated with larger RVEDV among women and larger RV end-systolic volume in both sexes.
  
  
  CONCLUSIONS
  SSRI use was associated with higher RVSV in cardiovascular disease-free individuals and, among men, greater RV mass and larger RVEDV. The effects of SSRI use in patients with (or at risk for) RV dysfunction and the role of sex in modifying this relationship warrant further study.
authors.affiliation: Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
authors.forename: Corey E
authors.initials: CE
authors.lastname: Ventetuolo
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Aditya
authors.initials: A
authors.lastname: Jain
authors.forename: Joseph A C
authors.initials: JA
authors.lastname: Delaney
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Hundley
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kawut
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000208:ethnology* / Q000503:physiopathology; D002306:Cardiac Volume / Q000187:drug effects; D003971:Diastole / Q000187:drug effects; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology* / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000187:drug effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D012727:Sex Characteristics; D013318:Stroke Volume / Q000187:drug effects; D016276:Ventricular Function / Q000187:drug effects*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors