Relation of depression to heart rate nonlinear dynamics in patients ≥60 years of age with recent unstable angina pectoris or acute myocardial infarction

Vigo, Daniel Eduardo; Siri, Leonardo Nicola; Guevara, Miguel; Martı́nez-Martı́nez, José A.; Fahrer, Rodolfo; Cardinali, Daniel P.; Masoli, Osvaldo; Guinjoan, Salvador M.

doi:10.1016/j.amjcard.2003.11.056

Cited by 58 publications

(58 citation statements)

References 7 publications

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“…This is surprising given that 1) reductions in HRV are known to occur in a number of neuropsychiatric disorders (28,29,58,62) and 2) Miyajima and colleagues (37) reported a highly significant relationship between decreased HRV and gastric dysmotility in patients with cirrhosis and a positive correlation between gastric motility and the degree of hepatic encephalopathy.…”

Section: Discussionmentioning

confidence: 76%

“…Several mechanisms have been proposed to explain reduced heart rate fluctuations in these patients (28,29,58,62). However, the possibility that the changes in HRV observed in patients with neuropsychiatric impairment might relate to the overproduction of inflammatory cytokines does not seem to have been considered in the studies undertaken to date.…”

mentioning

confidence: 79%

“…Decreased HRV has also been reported in several neuropsychiatric conditions, such as dementia (29,62), mood disorders in postmenopausal women (28), and depression in patients with ischemic heart disease (58). Several mechanisms have been proposed to explain reduced heart rate fluctuations in these patients (28,29,58,62).…”

mentioning

confidence: 99%

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Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Mani¹,

Montagnese²,

Jackson³

et al. 2009

American Journal of Physiology-Gastrointestinal and Liver Physi

111

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Mani AR, Montagnese S, Jackson CD, Jenkins CW, Head IM, Stephens RC, Moore KP, Morgan MY. Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy. Am J Physiol Gastrointest Liver Physiol 296: G330 -G338, 2009. First published November 20, 2008 doi:10.1152/ajpgi.90488.2008.-Heart rate variability (HRV) is reduced in several clinical settings associated with either systemic inflammation or neuropsychiatric impairment. The possibility that the changes in HRV observed in patients with neuropsychiatric impairment might relate to the overproduction of inflammatory cytokines does not seem to have been considered in the studies undertaken to date. HRV is decreased in patients with liver cirrhosis but its relationship to the impairment of neuropsychiatric performance, commonly observed in these patients, is unknown. The aim of this study was to investigate the relationship between HRV, hepatic encephalopathy, and production of inflammatory cytokines in patients with cirrhosis. Eighty patients with cirrhosis [53 men, 27 women; mean (Ϯ1SD) age 54 Ϯ 10 yr], classified as neuropsychiatrically unimpaired or as having minimal or overt hepatic encephalopathy, and 11 healthy subjects were studied. HRV was assessed by applying Poincaré plot analysis to the R-R interval series on a 5-min ECG. Inflammatory cytokines (TNF-␣, IL-6, IL-10, and IL-12) were measured in a subgroup of patients. Long-term R-R variability was significantly decreased in the patients with cirrhosis, in parallel with the degree of neuropsychiatric impairment (P Ͻ 0.01) and independently of the degree of hepatic dysfunction (P ϭ 0.011). The relative risk of death increased by 7.7% for every 1-ms drop in this variable. Plasma levels of IL-6 significantly correlated with indexes of both HRV and neuropsychiatric performance. The changes observed in HRV and in neuropsychiatric status in patients with cirrhosis are significantly correlated, most likely reflecting a common pathogenic mechanism mediated by inflammatory cytokines.

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Section: Discussionmentioning

confidence: 76%

mentioning

confidence: 79%

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Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Mani¹,

Montagnese²,

Jackson³

et al. 2009

American Journal of Physiology-Gastrointestinal and Liver Physi

111

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“…The available data show that the most commonly used functions are: The Power Law Slope, 2,10,17,18 the Short-Term Fractal Scaling Exponent (or Alpha 1 exponent), calculated by means of Detrended Fluctuation Analysis (DFA1), 11,12,[17][18][19][20][21][22][23] the quantification of Poincaré Plots [21][22][23] and the Correlation Dimension (D2) (or modified calculation of the Pointwise Correlation Dimension), 10,[23][24][25] the results of which have been subjected to the usual statistical evaluations; by contrast, the clustering procedure utilized in the present study appears to be totally different and innovative. In fact, it enables a series of consecutive points of the ECG signal to be transformed into a numerical series.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Nonlinear Analysis of ECG Signals for Prediction of Inducibility of Sustained Ventricular Tachycardia by Programmed Ventricular Stimulation in Patients with Complex Spontaneous Ventricular Arrhythmias

Durin¹,

Pedrinazzi²,

Donato³

et al. 2008

Noninvasive Electrocardiol

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Introduction:The aim of our study was to assess the effectiveness of the nonlinear analysis (NLA) of ECG in predicting the results of invasive electrophysiologic study (EPS) in patients with ventricular arrhythmias.Methods: We evaluated 25 patients with history of cardiac arrest, syncope, sustained, or nonsustained ventricular tachycardia (VT). All patients underwent electrophysiologic study (EPS) and nonlinear analysis (NLA) of ECG. The study group was compared with a control group of 25 healthy subjects, in order to define the normal range of NLA. ECG was processed in order to obtain numerical values, which were analyzed by nonlinear mathematical functions. Patients were classified through the application of a clustering procedure to the whole set of functions, and the correlation between the results of nonlinear analysis of ECG and EPS was tested.Results: NLA assigned all patients with negative EPS to the same class of healthy subjects, whereas the patients in whom VT was inducible had been correctly and clearly isolated into a separate cluster. In our study, the result of NLA with application of the clustering technique was significantly correlated to that of EPS (P < 0.001), and was able to predict the result of EPS, with a negative predictive value of 100% and a positive predictive value of 100%.Conclusions: NLA can predict the results of EPS with good negative and positive predictive value. However, further studies are needed in order to verify the usefulness of this noninvasive tool for sudden death risk stratification in patients with ventricular arrhythmias.

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“…The right anterior insula has a role in modulation of sympathetic tone and is implicated in the sympathetic arousal associated with mental tasks. Major depression and depressive symptoms are associated with decreased HRV, both in patients with coronary heart disease (Carney et al, 2001;Vigo et al, 2004) and in community subjects (Udupa et al, 2007;van der Kooy et al, 2006). Depression has been associated with increased risk of morbidity and mortality in patients with coronary artery disease (Lett et al, 2004).…”

Section: Pathologic Influences On Heart Rate Variabilitymentioning

confidence: 99%

Electrocardiographic Analysis of Heart Rate Variability in Aging Heart

Santillo¹,

Migale²,

Fallavollita³

et al. 2012

Advances in Electrocardiograms - Methods and Analysis

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Relation of depression to heart rate nonlinear dynamics in patients ≥60 years of age with recent unstable angina pectoris or acute myocardial infarction

Cited by 58 publications

References 7 publications

Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Usefulness of Nonlinear Analysis of ECG Signals for Prediction of Inducibility of Sustained Ventricular Tachycardia by Programmed Ventricular Stimulation in Patients with Complex Spontaneous Ventricular Arrhythmias

Electrocardiographic Analysis of Heart Rate Variability in Aging Heart

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