Heart rate variability depression in patients with unstable angina

Huang, Jian; Sopher, S. Mark; Leatham, E; Redwood, Simon; Camm, A. John; Kaski, Juan Carlos

doi:10.1016/0002-8703(95)90076-4

Cited by 43 publications

(30 citation statements)

References 31 publications

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“…Several recent studies have suggested that autonomic dysfunction, represented by low HRV, may be one of the more promising potential explanations. Depression has been associated with low HRV in the setting of acute MI, 12,17 and low HRV is associated Table 1 (except depression score) were entered into the multivariable models. Other variables associated with SDNN (at PϽ.05) were ␤-blockers, resting heart rate, diabetes mellitus, congestive heart failure, COPD or asthma, and current smoking.…”

Section: Commentmentioning

confidence: 99%

Depression and Heart Rate Variability in Patients With Stable Coronary Heart Disease

Gehi¹,

Mangano²,

Pipkin³

et al. 2005

Arch Gen Psychiatry

113

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Context: Depression is associated with low heart rate variability (HRV) in patients following myocardial infarction, suggesting that alterations in the autonomic nervous system may contribute to the adverse cardiac outcomes associated with depression. Whether depression is associated with low HRV in patients with stable coronary heart disease (CHD) is not known.Objective: To examine the association between major depression and 24-hour HRV in patients with stable CHD.Design, Setting, and Participants: Cross-sectional study of 873 outpatients with stable CHD recruited from outpatient clinics in the San Francisco Bay Area, California. Main Outcome Measures:Major depression was assessed using the Computerized National Institute of Mental Health Diagnostic Interview Schedule. Heart rate variability was measured by 24-hour ambulatory electrocardiography.Results: A total of 195 participants (22%) had major depression. Overall, we observed no association between depression and HRV as measured by time domain or frequency domain variables. Mean HRV was similar in participants with and without depression (all P values Ͼ.10), and participants with depression were no more likely than those without depression to have low HRV (all P values Ͼ.10). Conclusions:We found no evidence of an association between depression and HRV in 873 outpatients with stable CHD. These findings raise questions about the potential role of HRV in the association between depression and cardiovascular disease. Psychiatry. 2005;62:661-666 Arch Gen

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Section: Commentmentioning

confidence: 99%

Depression and Heart Rate Variability in Patients With Stable Coronary Heart Disease

Gehi¹,

Mangano²,

Pipkin³

et al. 2005

Arch Gen Psychiatry

113

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“…, 60, pages 5-11 . ..................................................................................................................................................................................................................... population [21] and in non-surgical patients with acute coronary artery disease [15,[22][23][24][25][26] and congestive heart failure [27][28][29]. A decrease in heart rate variability is mainly explained by an imbalance of the sympathetic and parasympathetic nervous systems [15,24] and central regulatory impairment [27].…”

Section: Pre-operative Clinical Findingsmentioning

confidence: 99%

Predictors of long‐term mortality and cardiac events in patients with known or suspected coronary artery disease who survive major non‐cardiac surgery

Filipovic

Jeger²,

Girard

et al. 2004

Anaesthesia

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SummaryThe aim of this prospective study was to assess predictors of long-term outcome in patients with documented or suspected coronary artery disease who survive major non-cardiac surgery. The impact of patients' comorbidities, pre-operative heart rate variability and postoperative increase in cardiac troponin I on all-cause mortality and major cardiac events within 2 years was explored using multivariable logistic regression. Six of 173 patients died within the first month after surgery and were excluded from the study. Thirty-four of 167 patients (20%) died 1-24 months after surgery. Independent predictors of all-cause mortality were history of congestive heart failure (odds ratio 6.4 [95%, confidence interval 1.7-24]), pre-operatively depressed heart rate variability (odds ratio 6.4 [95%, confidence interval 1.9-21]), and age > 70 years (odds ratio 4.5 [95%, confidence interval 1.2-16]). In contrast, postoperative elevation of cardiac troponin I did not independently predict all-cause mortality or major cardiac events.

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“…Low heart rate variability (HRV) predicts an adverse prognosis in patients with an acute myocardial infarction (MI) [1,2,3] and unstable angina pectoris [4, 5]. Previous studies investigating the prognostic implications of HRV in stable angina pectoris have had limited information on valid hard endpoints [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Differential Index: A Simple Time Domain Heart Rate Variability Analysis with Prognostic Implications in Stable Angina Pectoris

et al. 2008

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Objectives: To examine the usefulness of time domain heart rate variability (HRV) measurements by a simple graphical method, the differential index (DI), in prognostic assessments of patients with chronic stable angina pectoris. Methods: HRV measurements in the time domain by DI were compared to conventional measurements of standard deviation of all normal-to-normal intervals (SDNN), percent of differences between adjacent normal RR intervals >50 ms (PNN50) and square root of the mean of the sum of squares of differences between adjacent normal RR intervals (RMSSD) from 24-hour ambulatory electrocardiographic recordings in 678 patients in the Angina Prognosis Study in Stockholm. The patients received double-blind treatment with metoprolol or verapamil. Main outcome measures were cardiovascular death or non-fatal myocardial infarction during follow-up (median 40 months). Results: Patients suffering cardiovascular death (n = 30) had lower DI, SDNN and PNN50 (all p < 0.001). In a multivariate Cox model, DI below median independently predicted cardiovascular death (p = 0.002), as did SDNN (p = 0.016) and PNN50 (p = 0.030), but not RMSSD (p = 0.10). The separation of survival curves was most pronounced and specificity was slightly better with DI. DI and PNN50 increased with metoprolol but not verapamil treatment. Short-term treatment effects were not related to prognosis. Conclusions: Low time domain HRV carries independent prognostic information regarding cardiovascular death in stable angina pectoris. The simple DI method provided equally good or better prognostic information than conventional, more laborious HRV methods.

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Heart rate variability depression in patients with unstable angina

Cited by 43 publications

References 31 publications

Depression and Heart Rate Variability in Patients With Stable Coronary Heart Disease

Depression and Heart Rate Variability in Patients With Stable Coronary Heart Disease

Predictors of long‐term mortality and cardiac events in patients with known or suspected coronary artery disease who survive major non‐cardiac surgery

Differential Index: A Simple Time Domain Heart Rate Variability Analysis with Prognostic Implications in Stable Angina Pectoris

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