Depression, heart rate variability, and acute myocardial infarction
Depression, heart rate variability, and acute myocardial infarction
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DOI：
10.1161/hc4201.097834
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发表时间：
2001-10-23
期刊：
影响因子：
37.8
通讯作者：
Freedland, KE
中科院分区：
文献类型：
--
作者：
Carney, RM;Blumenthal, JA;Freedland, KE
临床抑郁症与近期心肌梗死（MI）患者死亡风险增加相关。心率变异性（HRV）降低被认为是这种关联的可能解释。本研究的目的是确定抑郁症是否与近期MI患者的HRV降低有关。方法和结果招募了380例伴有抑郁症的急性MI患者和424例无抑郁症的急性MI患者。所有患者出院后均接受24小时动态心电图监测。在单因素分析中，抑郁症患者HRV的4项指标均显著低于非抑郁症患者。与HRV相关的变量在抑郁症患者和非抑郁症患者之间进行了比较，并确定了潜在的混淆。这些变量（年龄，性别，糖尿病，目前吸烟）进入协方差模型分析，其次是抑郁状态。在最终的模型中，所有，但一个HRV指数（高频功率）仍然显着低于抑郁症患者比患者没有depress.Conclusions，我们得出结论，更大的自主神经功能障碍，反映了降低HRV，是一个合理的机制，抑郁症增加心肌梗死后患者的心脏死亡率。
Background-Clinical depression is associated with an increased risk for mortality in patients with a recent myocardial infarction (MI). Reduced heart rate variability (HRV) has been suggested as a possible explanation for this association. The purpose of this study was to determine if depression is associated with reduced HRV in patients with a recent MI.Methods and Results-Three hundred eighty acute MI patients with depression and 424 acute MI patients without depression were recruited. All underwent 24-hour ambulatory electrocardiographic monitoring after hospital discharge. In univariate analyses, 4 indices of HRV were significantly lower in patients with depression than in patients without depression. Variables associated with HRV were then compared between patients with and without depression, and potential confounds were identified. These variables (age, sex, diabetes, and present cigarette smoking) were entered into an analysis of covariance model, followed by depression status. In the final model, all but one HRV index (high-frequency power) remained significantly lower in patients with depression than in patients without depression.Conclusions-We conclude that greater autonomic dysfunction, as reflected by decreased HRV, is a plausible mechanism linking depression to increased cardiac mortality in post-MI patients.