Heart rate variability status at rest in adult depressed patients: a systematic review and meta-analysis

Abstract

PurposesA meta-analysis was conducted to examine the differences in heart rate variability (HRV) between depressed patients and healthy individuals, with the purpose of providing a theoretical basis for the diagnosis of depression and the prevention of cardiovascular diseases.MethodsTo search China National Knowledge Infrastructure (CNKI), WanFang, VIP, PubMed, Web of Science, Science Direct, and Cochrane Library databases to collect case–control studies on HRV in depressed patients, the retrieval date is from the establishment of the database to December 2022. Effective Public Health Practice Project (EPHPP) scale was used to evaluate literature quality, and Stata14.0 software was used for meta-analysis.ResultsThis study comprised of 43 papers, 22 written in Chinese and 21 in English, that included 2,359 subjects in the depression group and 3,547 in the healthy control group. Meta-analysis results showed that compared with the healthy control group, patients with depression had lower SDNN [Hedges’ g = −0.87, 95% CI (−1.14, −0.60), Z = −6.254, p < 0.01], RMSSD [Hedges’ g = −0.51, 95% CI (−0.69,-0.33), Z = −5.525, p < 0.01], PNN50 [Hedges’ g = −0.43, 95% CI (−0.59, −0.27), Z = −5.245, p < 0.01], LF [Hedges’ g = −0.34, 95% CI (−0.55, − 0.13), Z = −3.104, p < 0.01], and HF [Hedges’ g = −0.51, 95% CI (−0.69, −0.33), Z = −5.669 p < 0.01], and LF/HF [Hedges’ g = −0.05, 95% CI (−0.27, 0.18), Z = −0.410, p = 0.682] showed no significant difference.ConclusionThis research revealed that HRV measures of depressed individuals were lower than those of the healthy population, except for LF/HF, suggesting that people with depression may be more at risk of cardiovascular diseases than the healthy population.

Developing a Five-Minute Normative Database of Heart Rate Variability for Diagnosing Cardiac Autonomic Dysregulation for Patients with Major Depressive Disorder

“…These results align with Borrione et al’s [ 32 ] findings, which demonstrated a negative correlation between depressive symptoms and LF of HRV and a positive correlation with the LF/HF ratio. These data suggest vagal withdrawal in patients with MDD [ 14 , 17 , 19 ]. Additionally, the HRV indices demonstrated a decline with age in both the MDD and HC groups [ 28 ].…”

“…Porges [ 14 ] proposed the polyvagal theory to elucidate the complex interplay between cardiac autonomic function, emotional regulation, and social interaction behavior. Previous studies demonstrated that patients with MDD exhibited diminished vagal modulation at rest [ 15 , 16 , 17 , 18 , 19 ] as well as during laboratory-induced emotion tasks, such as viewing sad films. A meta-analysis involving 43 studies encompassing 2359 patients with depression and 3547 healthy controls revealed that patients with depression had lower HRV indices (SDNN, RMSSD, pNN50, LF, and HF) compared to the healthy controls; however, no significant difference was observed in the LF/HF ratio between the two groups [ 19 ].…”

“…Previous studies demonstrated that patients with MDD exhibited diminished vagal modulation at rest [ 15 , 16 , 17 , 18 , 19 ] as well as during laboratory-induced emotion tasks, such as viewing sad films. A meta-analysis involving 43 studies encompassing 2359 patients with depression and 3547 healthy controls revealed that patients with depression had lower HRV indices (SDNN, RMSSD, pNN50, LF, and HF) compared to the healthy controls; however, no significant difference was observed in the LF/HF ratio between the two groups [ 19 ]. Rottenberg [ 17 , 20 ] and Porges [ 14 ] indicated that reduced HRV is associated with decreased flexibility and adaptability of the cardiac vagal control.…”