Heart rate variability measurement and clinical depression in acute coronary syndrome patients: narrative review of recent literature

Abstract

AimWe aimed to explore links between heart rate variability (HRV) and clinical depression in patients with acute coronary syndrome (ACS), through a review of recent clinical research literature.BackgroundPatients with ACS are at risk for both cardiac autonomic dysfunction and clinical depression. Both conditions can negatively impact the ability to recover from an acute physiological insult, such as unstable angina or myocardial infarction, increasing the risk for adverse cardiovascular outcomes. HRV is recognized as a reflection of autonomic function.MethodsA narrative review was undertaken to evaluate state-of-the-art clinical research, using the PubMed database, January 2013. The search terms “heart rate variability” and “depression” were used in conjunction with “acute coronary syndrome”, “unstable angina”, or “myocardial infarction” to find clinical studies published within the past 10 years related to HRV and clinical depression, in patients with an ACS episode. Studies were included if HRV measurement and depression screening were undertaken during an ACS hospitalization or within 2 months of hospital discharge.ResultsNine clinical studies met the inclusion criteria. The studies’ results indicate that there may be a relationship between abnormal HRV and clinical depression when assessed early after an ACS event, offering the possibility that these risk factors play a modest role in patient outcomes.ConclusionWhile a definitive conclusion about the relevance of HRV and clinical depression measurement in ACS patients would be premature, the literature suggests that these measures may provide additional information in risk assessment. Potential avenues for further research are proposed.

Long noncoding NONRATT021972 siRNA normalized abnormal sympathetic activity mediated by the upregulation of P2X7 receptor in superior cervical ganglia after myocardial ischemia

“…HRV is a quantitative, noninvasive indicator of autonomic nervous function in the cardiovascular system [34,45,46]. LF represents the sympathetic activity and HF indicates the parasympathetic activity [45,46].…”

“…The ECG electrodes were subcutaneously fixed to both the upper and right lower limbs using the Medlab biological ECG signal acquisition and processing system to record a standard II lead electrocardiogram. The obtained ECG signals were analyzed by the HRV analysis software using a short duration 5 min frequency domain analysis method and a 5 min electrocardiogram for the HRV analysis [34,35]. The HRV frequency analysis consisted of the LF (ms, 0.04-0.15 Hz) and HF (ms, 0.15-0.40 Hz) components [36].…”

Effects of paroxetine-mediated inhibition of GRK2 expression on depression and cardiovascular function in patients with myocardial infarction

“… 7 , 8 The imbalance of these autonomic systems is manifested by decreased heart rate variability (HRV). 9 , 10 Excessive sympathetic activation may contribute to the detrimental effects of depression on cardiac function during or after myocardial infarction (MI). 11 HRV analysis is widely used as a noninvasive technique for the determination of autonomic nervous system (ANS) influence on heart rate.…”

Effect of Fasting Blood Glucose Level on Heart Rate Variability of Healthy Young Adults

“…Most previous studies utilized HRV in risk stratification of cardiac events especially following myocardial infarction [ 10 , 11 ]. In clinical practice, augmented sympathetic CAM is associated with low HRV and increased the risk of cardiac events among susceptible patients [ 4 , 5 ].…”