Autonomic dysfunction and heart rate variability in depression

Sgoifo, Andrea; Carnevali, Luca; Alfonso, M.; Amore, Mario

doi:10.3109/10253890.2015.1045868

Cited by 249 publications

(183 citation statements)

References 93 publications

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“…While the cross-sectional nature of this study does not allow definitive determination of causality, the consistent lower values of HRV shown here suggests that total cumulative stress, with its components of chronic stress and cumulative adverse life events, may contribute to a state of cardiac ANS dysfunction, independent of any existent mental or physical disease state. While prior studies have shown the effects of single specific stressors on HRV, including work stress, anxiety, low socioeconomic status, and depression (20, 21, 31, 56–58), this is the first to show that cumulative stress over the lifespan, as measured by the CAI total score, is associated with reduced HRV.…”

Section: Discussionmentioning

confidence: 62%

Cumulative stress and autonomic dysregulation in a community sample

Lampert

Tuit

Hong

et al. 2016

Stress

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Whether cumulative stress, including both chronic stress and adverse life events, is associated with decreased heart rate variability (HRV), a non-invasive measure of autonomic status which predicts poor cardiovascular outcomes, is unknown. Healthy community dwelling volunteers, (N= 157, mean age 29 years) participated in the Cumulative Stress/Adversity Interview, (CAI) a 140-item event interview measuring cumulative adversity including major life events, life trauma, recent life events and chronic stressors, and underwent 24 hour ambulatory ECG monitoring. HRV was analyzed in the frequency domain and standard deviation of NN intervals (SDNN) calculated. Initial simple regression analyses revealed that total cumulative stress score, chronic stressors, and cumulative adverse life events (CALE) were all inversely associated with ultra low frequency (ULF), very low frequency (VLF), and low frequency (LF) power and SDNN (all p<0.05). In hierarchical regression analyses, total cumulative stress and chronic stress each was significantly associated with SDNN and ULF even after the high significant contribution of age and sex, with no other covariates accounting for additional appreciable variance. For VLF and LF, both total cumulative stress and chronic stress significantly contributed to the variance were no longer significant after adjusting for race and health behaviors. (p’s<.05). In summary, total cumulative stress, and its components of adverse life events and chronic stress were associated with decreased cardiac autonomic function as measured by HRV. Findings suggest one potential mechanism by which stress may exert adverse effects on mortality in healthy individuals. Primary preventive strategies including stress management may prove beneficial.

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Section: Discussionmentioning

confidence: 62%

Cumulative stress and autonomic dysregulation in a community sample

Lampert

Tuit

Hong

et al. 2016

Stress

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“…Further studies have since documented adverse prognostic implications of reduced HRV in MI patients (Cripps et al, 1991; Tsuji et al, 1996; Boskovic et al, 2014; Song et al, 2014). Psychosocial factors, such as stressful life events (Pieper et al, 2010; van Ockenburg et al, 2015), general stress (Kang et al, 2004; Brosschot et al, 2006; Chandola et al, 2010; Chida and Steptoe, 2010), hostility (Virtanen et al, 2003; Chida and Steptoe, 2009), depression (Stein et al, 2000; Gehi et al, 2005; Ha et al, 2015; Sgoifo et al, 2015) and anxiety (Friedman and Thayer, 1998; Alvares et al, 2013) have all been found to be associated with lowered HRV. In addition, individuals with stronger emotion regulation (Thayer et al, 2009; Patron et al, 2014; Gillie et al, 2015) and adaptive coping strategies have been shown to have higher levels of HRV (Appelhans and Luecken, 2008; Thayer and Lane, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…In cardiac patients, illness perceptions, including loss of perceived control, negative emotional responses and greater consequences have variously been shown to be associated with psychological distress, such as anxiety and depressive symptoms (Sherry et al, 2005). Moreover, a range of psychosocial factors, including depression (Stein et al, 2000; Gehi et al, 2005; Ha et al, 2015; Sgoifo et al, 2015) and anxiety (Friedman and Thayer, 1998; Alvares et al, 2013), but also stressful life events (Pieper et al, 2010; van Ockenburg et al, 2015), general stress (Kang et al, 2004; Brosschot et al, 2006; Chandola et al, 2010; Chida and Steptoe, 2010) and hostility have all been found to be associated with lowered HRV. In addition, negative illness perceptions are associated with maladaptive health behaviors, such as lack in physical activity, which in turn might contribute to lower HRV.…”

Section: Introductionmentioning

confidence: 99%

Can Illness Perceptions Predict Lower Heart Rate Variability following Acute Myocardial Infarction?

et al. 2016

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Objective: Decreased heart rate variability (HRV) has been reported to be a predictor of mortality after myocardial infarction (MI). Patients' beliefs and perceptions concerning their illness may play a role in decreased HRV. This study investigated if illness perceptions predict HRV at 3 months following acute MI.Methods: 130 patients referred to a tertiary cardiology center, were examined within 48 h and 3 months following acute MI. At admission, patients' cognitive representations of their MI were assessed using the German version of the self-rated Brief Illness Perception Questionnaire (Brief IPQ). At admission and after 3 months (follow-up), frequency and time domain measures of HRV were obtained from 5-min electrocardiogram (ECG) recordings during stable supine resting.Results: Linear hierarchical regression showed that the Brief IPQ dimensions timeline (β coefficient = 0.29; p = 0.044), personal control (β = 0.47; p = 0.008) and illness understanding (β = 0.43; p = 0.014) were significant predictors of HRV, adjusted for age, gender, baseline HRV, diabetes, beta-blockers, left ventricular ejection fraction (LVEF), attendance of cardiac rehabilitation, and depressive symptoms.Conclusions: As patients' negative perceptions of their illness are associated with lower HRV following acute MI, a brief illness perception questionnaire may help to identify patients who might benefit from a specific illness perceptions intervention.

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“…Subjects with depression and anxiety disorders exhibit abnormal HRV patterns compared with non-psychiatric controls (Servant et al, 2009). Reduced HRV characterizes emotional dysregulation, decreased psychological flexibility and defective social engagement, which in turn are linked to prefrontal cortex hypoactivity (Sgoifo et al, 2015). High occupational stress has also been associated with lowered HRV, specifically with reduced parasympathetic activation.…”

Section: Non-medical Treatment Of Cardiac Autonomic Neuropathymentioning

confidence: 99%

Cardiac Autonomic Neuropathy in Diabetes: A Predictor of Cardiometabolic Events

et al. 2018

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Autonomic nervous system (ANS) imbalance manifesting as cardiac autonomic neuropathy in the diabetic population is an important predictor of cardiovascular events. Symptoms and signs of ANS dysfunction, such as resting heart rate elevations, diminished blood pressure responses to standing, and altered time and frequency domain measures of heart rate variability in response to deep breathing, standing, and the Valsalva maneuver, should be elicited from all patients with diabetes and prediabetes. With the recognition of the presence of ANS imbalance or for its prevention, a rigorous regime should be implemented with lifestyle modification, physical activity, and cautious use of medications that lower blood glucose. Rather than intensifying diabetes control, a regimen tailored to the individual risk of autonomic imbalance should be implemented. New agents that may improve autonomic function, such as SGLT2 inhibitors, should be considered and the use of incretins monitored. One of the central mechanisms of dysfunction is disturbance of the hypothalamic cardiac clock, a consequence of dopamine deficiency that leads to sympathetic dominance, insulin resistance, and features of the metabolic syndrome. An improvement in ANS balance may be critical to reducing cardiovascular events, cardiac failure, and early mortality in the diabetic population.

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Autonomic dysfunction and heart rate variability in depression

Cited by 249 publications

References 93 publications

Cumulative stress and autonomic dysregulation in a community sample

Cumulative stress and autonomic dysregulation in a community sample

Can Illness Perceptions Predict Lower Heart Rate Variability following Acute Myocardial Infarction?

Cardiac Autonomic Neuropathy in Diabetes: A Predictor of Cardiometabolic Events

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