Major depression with ischemic heart disease: Effects of paroxetine and nortriptyline on long-term heart rate variability measures
Major depression with ischemic heart disease: Effects of paroxetine and nortriptyline on long-term heart rate variability measures
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DOI：
10.1016/s0006-3223(02)01394-x
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发表时间：
2002-09-01
影响因子：
10.6
通讯作者：
Roose, S
中科院分区：
文献类型：
--
作者：
Yeragani, VK;Pesce, V;Roose, S
背景：研究表明抑郁症与心脏病患者的猝死和严重心血管事件有关。最近的研究表明，心脏病伴抑郁症患者和无心脏病的抑郁症患者迷走神经功能下降。我们比较了20小时，睡眠和清醒的心脏周期变异性措施，使用频谱分析，分形维数，抑郁症和缺血性心脏病两组患者的符号动力学结果：频谱测量显示清醒和睡眠总功率降低，（TP：0.0-0.5 Hz），超低频电源（ULF：0-0.0033 Hz），极低频电源（VLF：0.0033-0.04 Hz）和低频电源（LF：0.04-0.15 Hz）和高频功率降低（HF：0.15-0.5 Hz）的清醒状态下接受去甲替林的患者。一个措施的非线性复杂性，WC-100，显著增加帕罗西汀后清醒condition.Conclusions：这些研究结果表明，去甲替林有较强的迷走神经对心脏自主神经功能的影响相比，帕罗西汀，这是在协议与以前的临床和临床前报告。帕罗西汀可能具有一定的心脏保护作用，尤其是在心脏病患者中。
Background: Studies have linked depression to sudden death and serious cardiovascular events in patients with preexisting cardiac illness. Recent studies have shown decreased vagal function in cardiac patients with depression and depressed patients without cardiac illness.Methods: We compared 20-hour, sleeping, and awake heart period variability measures using spectral analysis, fractal dimension, and symbolic dynamics in two patient groups with major depression and ischemic heart disease (mean age 59-60 years) before and after 6 weeks of paroxetine or nortriptyline treatment.Results: Spectral measures showed decreases in awake and sleeping total power (TP: 0.0-0.5 Hz), ultra low frequency power (ULF: 0-0.0033 Hz), very low frequency power (VLF: 0.0033-0.04 Hz), and low-frequency power (LF: 0.04-0.15 Hz) for nortriptyline condition and a decrease in high-frequency power (HF: 0.15-0.5 Hz) for the awake condition in patients who received nortriptyline. A measure of nonlinear complexity, WC-100, significantly increased after paroxetine during the awake condition.Conclusions: These findings suggest that nortriptyline has stronger vagolytic effects on cardiac autonomic function compared with paroxetine, which is in agreement with previous clinical and preclinical reports. Paroxetine may have some cardio-protective effects, especially in cardiac patients.