Heart rate variability and markers of inflammation and coagulation in depressed patients with coronary heart disease

Carney, Robert M.; Freedland, Kenneth E.; Stein, Phyllis K.; Miller, Gregory E.; Steinmeyer, Brian C.; Rich, Michael W.; Duntley, Stephen P.

doi:10.1016/j.jpsychores.2006.12.004

Cited by 101 publications

(68 citation statements)

References 27 publications

(26 reference statements)

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“…Dysregulation of the hypothalmic-pituitary-adrenal axis in depressed states may also play a role, particularly with regard to effect on stress responses, either biochemically with inflammatory cytokine imbalances or clinically through abnormalities of BP and heart rate (28)(29)(30). Furthermore, autonomic nervous system dysfunction may accompany depression, further exacerbating BP and heart rate dysregulation and potentially manifesting with reduced heart rate variability and cardiac baroreflexes that may further aggravate cardiovascular morbidity (31)(32)(33). While inflammation and autonomic dysfunction are not uncommon in patients undergoing HD (34,35), depression may represent an aggravating factor toward greater morbidity.…”

Section: Discussionmentioning

confidence: 99%

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Lacson

Bruce

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Recent studies demonstrated an association between depressive affect and higher mortality risk in incident hemodialysis patients. This study sought to determine whether an association also exists with hospitalization risk.Design, setting, participants, & measurements All 8776 adult incident hemodialysis patients with Medical Outcomes Study Short Form 36 survey results treated in Fresenius Medical Care North America facilities in 2006 were followed for 1 year from the date of survey, and all hospitalization events lasting .24 hours were tracked. A depressive affect score was derived from responses to two Medical Outcomes Study Short Form 36 questions ("down in the dumps" and "downhearted and blue"). A high depressive affect score corresponded with an average response of "some of the time" or more frequent occurrence. Cox and Poisson models were constructed to determine associations of depressive affect scores with risk for time to first hospitalization and risk for hospitalization events, as well as total days spent in the hospital, respectively.Results Incident patients with high depressive affect score made up 41% of the cohort and had a median (interquartile range) hospitalization event rate of one (0, 3) and 4 (0, 15) total hospital days; the values for patients with low depressive affect scores were one (0, 2) event and 2 (0, 11) days, respectively. For high-scoring patients, the adjusted hazard ratio for first hospitalization was 1.12 (1.04, 1.20). When multiple hospital events were considered, the adjusted risk ratio was 1.13 (1.02, 1.25) and the corresponding risk ratio for total hospital days was 1.20 (1.07, 1.35). High depressive affect score was generally associated with lower physical and mental component scores, but these covariates were adjusted for in the models.Conclusions Depressive affect in incident hemodialysis patients was associated with higher risk of hospitalization and more hospital days. Future studies are needed to investigate the effect of therapeutic interventions to address depressive affect in this high-risk population.

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Section: Discussionmentioning

confidence: 99%

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Lacson

Bruce

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…Currently, the HRV indexes have been used to understand various conditions, such as coronary artery disease [54][55][56][57], cardiomyopathy [26.58], arterial hypertension [29,[59][60][61], myocardial infarction [62][63][64], sudden death [65], chronic obstructive pulmonary disease [2,66,67], renal failure [68], heart failure [69], diabetes [70], stroke [71], Alzheimer's disease [72] leukemia [73], obstructive sleep apnea [74], epilepsy [75], headache [76], among others.…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…Table 2 shows studies using HRV in various physiological and pathological conditions. Carnethon et al [56] Novais et al [29] Menezes et al [60] Terathongkum et al [61] Takahashi et al [55] Bittencourt et al [26] Pecyna [63] Carney et al [54] Limongelli et al [58] Karas et al [59] Larosa et al [62] Javorka et al [38] Catai et al [7] Weerapong et al [41] Mello et al [37] Paschoal et al [72] Sin DD et al [66] Kudaiberdieva et al [65] Lopes et al [71] Neves et al [73] Furuland et al [68] Lopes et al [79] and Paschoal et al [80] observed that the aging process causes a depletion of vagal tone and consequent increase in sympathetic activity, therefore older individuals have a lower HRV. In 2006, Rajendra Acharya et al [4] observed that HRV is lower with age and the variation is greater in women.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Noções básicas de variabilidade da frequência cardíaca e sua aplicabilidade clínica

Vanderlei

Pastre

Hoshi

et al. 2009

Rev Bras Cir Cardiovasc

659

499

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Autonomic nervous system (ANS) plays an important role in the regulation of the physiological processes of the human organism during normal and pathological conditions. Among the techniques used in its evaluation, the heart rate variability (HRV) has arising as a simple and non-invasive measure of the autonomic impulses, representing one of the most promising quantitative markers of the autonomic balance. The HRV describes the oscillations in the interval between consecutive heart beats (RR interval), as well as the oscillations between consecutive instantaneous heart rates. It is a measure that can be used to assess the ANS modulation under physiological conditions, such as wakefulness and sleep conditions, different body positions, physical training and also pathological conditions. Changes in the HRV patterns provide a sensible and advanced indicator of health involvements. Higher HRV is a signal of good adaptation and characterizes a health person with efficient autonomic mechanisms, while lower HRV is frequently an indicator of abnormal and insufficient adaptation of the ANS, provoking poor patient's physiological function. Because of its importance as a marker that reflects the autonomic nervous system activity on the sinus node and as a clinical instrument to assess and identify health involvements, this study reviews conceptual aspects of the HRV, measurement devices, filtering methods, indexes used in the HRV analyses, limitations in the use and clinical applications of the HRV.Descriptors: Autonomic nervous system. Heart rate. Parasympathetic nervous system. Sympathetic nervous system. ResumoO sistema nervoso autônomo (SNA) desempenha um papel importante na regulação dos processos fisiológicos do organismo humano tanto em condições normais quanto patológicas. Dentre as técnicas utilizadas para sua avaliação, a variabilidade da frequência cardíaca (VFC) tem emergido como uma medida simples e não-invasiva dos impulsos autonômicos, representando um dos mais promissores marcadores quantitativos do balanço autonômico. A VFC descreve as oscilações no intervalo entre batimentos cardíacos consecutivos (intervalos R-R), assim como oscilações entre frequências cardíacas instantâneas consecutivas. Trata-se de uma medida que pode ser utilizada para avaliar a modulação do SNA sob condições fisiológicas, tais como em situações de vigília e sono, diferentes posições do corpo, treinamento físico, e também em condições patológicas. Mudanças nos padrões da VFC fornecem um indicador sensível e antecipado de comprometimentos na

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“…2 Depression has been linked to having a higher number of Framingham risk factors (i.e., smoking, obesity, sedentary lifestyle) for cardiac disease in patients with diabetes. 3 Depression is also associated with physiologic dysregulation of the hypothalamic-pituitary axis (HPA) 4 and sympathetic nervous system 5,6 as well as an increase in inflammatory markers, 7,8 which may also adversely affect the course of diabetes. Given the adverse effect on self-care and physiologic dysregulation, it is not surprising that longitudinal studies have also shown that depression is linked with an increased risk of microvascular and macrovascular complications.…”

Section: Introductionmentioning

confidence: 99%

Depression and Diabetes: A Potentially Lethal Combination

et al. 2008

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OBJECTIVE:To assess whether Medicare fee-forservice beneficiaries with depression and diabetes had a higher mortality rate over a 2-year period compared with beneficiaries with diabetes alone. DESIGN: Evidence of depression was based on a physician diagnosis or self-reported prescription of an antidepressant in the year prior to screening, or a score of ≥3 on the Patient Health Questionnaire two-item questionnaire. Mortality was assessed bi-monthly by checking Medicare claims and eligibility files or from information from telephone contact with the participant's family. Cox proportional hazard regression models were used to calculate adjusted hazard ratios of death in depressed versus nondepressed beneficiaries with diabetes.PARTICIPANTS: A total of 10,704 beneficiaries with diabetes enrolled in a disease management program were surveyed with a health assessment questionnaire and followed over a two-year period. MAIN RESULTS:Comorbid depression in Medicare beneficiaries with diabetes participating in a disease management program was associated with an increased risk for all-cause mortality over a two-year period of approximately 36% to 38%, depending on the definition of depression that was used. No significant increase in rates of cause-specific mortality from macrovascular disease were found in depressed versus nondepressed beneficiaries. CONCLUSION:Among a large Medicare cohort of feefor-service beneficiaries with diabetes, comorbid depression was associated with an increase in all-cause mortality over a two-year period. Future research will be required to determine whether the increase in mortality associated with depression is due to potential behavioral mediators (i.e., smoking, poor adherence to diet) or physiologic abnormalities (i.e., hypothalamic-pituitary axis dysregulation) associated with depression.

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Heart rate variability and markers of inflammation and coagulation in depressed patients with coronary heart disease

Cited by 101 publications

References 27 publications

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Noções básicas de variabilidade da frequência cardíaca e sua aplicabilidade clínica

Depression and Diabetes: A Potentially Lethal Combination

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