Changes In Heart Rate Variability In Depressed Patient
Changes In Heart Rate Variability In Depressed Patient
Keywords:
Autonomic nervous system, Autonomic Function, Major Depressive DisorderAbstract
Background: Major depressive disorder is most common mood disorder and is one of the most burdensome and disabling disease in the world. Abnormalities in the hypothalamic-pituitary adrenal (HPA) axis in depressed patients play a substantial role in autonomic dysregulation, as patient with depression have elevated levels of cortisol. The present study was conducted with a motive to compare and evaluate the effects of depression on cardiovascular autonomic functioning compared with healthy controls. Methodology: In this study 72 subjects were selected out of that 36 were depressed and 36 were control. All depressed patient were taken from outpatient department of Psychiatry. All subjects were between the age group of 18- 60 years. Control group were students and employees of Surat Municipal Corporation (SMC) having no current or past psychiatric illness. HRV test was done in a well-lighted and ventilated room of Physiology Department. 5 minute ECG recording with 16 channel digital polywrite were taken at resting state. ECG was analysed on Kubios HRV analysis software version 1.1, for calculation of frequency domain parameter. Results: On analysis it was revealed that depressed patients showed altered values of HF component of HRV (23.33 +34.454) than control group (118.31 + 201.186), which is significantly lower (p< 0.05) indicating lower parasympathetic activity. Conclusion: The findings from this study are consistent with the hypothesis that cardiac autonomic dysfunction is experienced by individuals with depression, especially decreased parasympathetic nerve. [Chaudhary R. NJIRM 2015; 6(2):61-65]
References
2. Carney RM, Freedland KE, Rich MW. Depression as a risk factor for cardiac events in established coronary artery disease: a review of possible mechanisms. Ann Behav Med 1995;17: 142-149.
3. Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction: impact on 6-month survival. JAMA. 1993;270:1819-1825.
4. Glassman AH, Shapiro PA. Depression and the course of coronary artery disease. Am J Psychiatry 1998;155:4-11.
5. Carney RM, Blumenthal JA, Stein PK, Watkins L, Catellier D, Berkman LF, Czajkowski SM. Depression, Heart rate Variability, and Acute Myocardial Infarction. Circulation 2001;104:2024-2028.
6. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart Rate Variability: Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996;17:354-381
7. Yeragani VK. Heart Rate and Blood Pressure Variability: Implications for Psychiatric Research. Neuropsychobiology 1995;32:182-191.
8. Gorman, J.M. & Sloan, R.P. (2000) Heart rate variability in depressive and anxiety disorders. American Heart Journal, 140, 77–83.
9. Sheps, D.S. & Sheffield, D. (2001) Depression, anxiety, and the cardiovascular system: the
cardiologist’s perspective. Journal of Clinical Psychiatry, 62 (Suppl. 8),12–16.
10. Rugulies, R. (2002) Depression as a predictor for coronary heart disease. A review and meta-analysis. American Journal of Preventive Medicine, 23, 51–61.
11. ESC/NASPE (European Society of Cardiology/North American Society of Pacing and Electrophysiology) Task Force (1996) Heart rate variability: standards of measurements, physiological interpretation, and clinical use. Circulation, 93, 1043–1065.
12. Malik, M. (1998) Heart rate variability. Current Opinion inCardiology, 13, 36–44.
13. La Rovere, M.T., Pinna, G.D., Hohnloser, S.H. et al. (2001) Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials. Circulation,103, 2072–2077.
14. Lombardi, F. (2002) Clinical implications of present physiological understanding of HRV components. Cardiac Electrophysiology Review, 6, 245–249.
15. Rottenberg, J., Wilhelm, F. H., Gross, J.J. & Gotlib, I.H.(2002) Respiratory sinus arrhythmia as a predictor of outcome in major depressive disorder. Journal ofAffective Disorders, 71, 265–272.
16. I.S.Anand, L.D. Fisher, Y.T. Chiang et al., “ changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan heart failure trial ( ValHeFT),†Ciculation, vol. 107, no.9, pp. 1278- 1283.
17. J.N. Cohn, T.B. Lavine, M.T. Olivari et al., “ plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure,†The new England Journal of Medicine, vol. 311, no. 13, pp. 819 – 823, 1984.
18. P.W. Gold, M.L.Wong, D.S.Goldstein et al., “ cardiac implications of increased arterial entry and reversible 24-h central and peripheral norepinephrine levels in malanocholia,†proceedings of the national Academy of sciences of the United states of America, vol. 102, no. 23, pp. 8303- 8308, 2005.
19. W. J.Kop,S.J.Synowski,and S.Sgottlieb,†Depression in heart failure: biobehaviourmechanisms, “ heart failure clinics, vol.7 no.1,pp. 23-38, 2011.
20. Bi Y, Hu XY, Wang Z: Research on sympathetic skin response in patients with depression. Chin J Phys Med Rehabil 2008, 30:819-822.
21. Li XH, Zhao RT, Guo YF, Hu YM, Zhang W, Zhao M, Yao L, Yang JG: The impact of depression on heart rate variability in patients with coronary heart disease. Chin Med Hera 2010, 12:1145-1147.
22. Tylee A, Haddad M, Barley E, Ashworth M, Brown J, Chambers J, Farmer A, Fortune Z, Lawton R, Leese M, Mann A, McCrone P, Murray J, Pariante C, Phillips R, Rose D, Rowlands G, Sabes-Figuera R, Smith A, Walters P: A pilot randomised controlled trial of personalised care for depressed patients with symptomatic coronary heart disease in South London general practices: the UPBEAT-UK RCT protocol and recruitment.BMC Psychiatry 2012, 6:12-58.
23. Charlson FJ, Stapelberg NJC, Baxter AJ, Whiteford HA: Should global burden of disease estimates include depression as a risk factor for coronary heart disease?BMC Med 2011, 9:1-6.
24. Spertus JA, McDonell M, Woodman CL, Fihn SD: Association between depression and worse disease-specific functional status in outpatients with coronary artery disease.Am Heart J 2000, 140:105-110.
25. Bhattacharyya MR, Whitehead DL, Rakhit R, Steptoe A: Depressed mood, positive affect, and heart rate variability in patients with suspected coronary artery disease. Psychosom Med 2008, 70:1020-1027
26. Berger S, Kliem A, Yeragani V, Bär KJ: Cardio-respiratory coupling in untreated patients with major depression. J Affect Disord 2012, 139:166-171.
27. Xu YG, Zhou SH, Li YG, Shen XQ, Hu XQ, Fang ZF, Chen S, Xu DM: Correlation between heart rate variability and coronary artery pathology in patients with coronary artery disease. Heart J 2007, 19:30-33.
28. Khawaja IS, Westermeyer JJ, Gajwani P, Feinstein RE: Depression and coronary artery disease: the association, mechanisms, and therapeutic implications. Psychiatry (Edgemont) 2009, 6:38-51.
