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Ding J, Wu Y, Wang B, Sun Z. The relationship between depression severity and heart rate variability in children and adolescents: A meta-analysis. J Psychosom Res 2024; 182:111804. [PMID: 38788284 DOI: 10.1016/j.jpsychores.2024.111804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 05/17/2024] [Accepted: 05/19/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE Depression in children and adolescents has gradually attracted social attention. Heart rate variability (HRV) has been found to be influenced by depression severity, but results have not been uniformed in children and adolescents. This study investigated the relationship between depression severity and heart rate variability in children and adolescents, aiming to provide additional evidence for an objective, effective, and convenient depression screening tool in this population. METHODS Literature searching was conducted in China National Knowledge Infrastructure (CNKI), Wanfang Data, Web of Science, PubMed, ScienceDirect, and EBSCO. Relevant studies investigating the relationship between depression severity and HRV in children and adolescents were selected for meta-analysis. RESULTS 31 articles were included in this meta-analysis, involving 4534 participants. Depression severity in children and adolescents was significantly negatively correlated with high frequency (HF) and root mean square of successive differences (RMSSD) in HRV (HF: r = -0.10, 95% CI: -0.17 to -0.04, p = 0.001; RMSSD: r = -0.18, 95% CI: -0.30 to -0.05, p = 0.01). The relationship between HF and depression severity was moderated by age, higher among those aged >12 than among those aged <12 (r = -0.17, -0.02, Q = 7.32, p = 0.007). CONCLUSION Heart rate variability is associated with depression severity in children and adolescents.
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Affiliation(s)
- Jiaxin Ding
- Institute of Applied Psychology, College of Education, Zhejiang University of Technology, 288 Liuhe Road, 310023 Hangzhou, Zhejiang Province, China
| | - Yi Wu
- Institute of Applied Psychology, College of Education, Zhejiang University of Technology, 288 Liuhe Road, 310023 Hangzhou, Zhejiang Province, China
| | - Bo Wang
- Institute of Applied Psychology, College of Education, Zhejiang University of Technology, 288 Liuhe Road, 310023 Hangzhou, Zhejiang Province, China
| | - Zaoyi Sun
- Institute of Applied Psychology, College of Education, Zhejiang University of Technology, 288 Liuhe Road, 310023 Hangzhou, Zhejiang Province, China.
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Baumeister-Lingens L, Rothe R, Wolff L, Gerlach AL, Koenig J, Sigrist C. Vagally-mediated heart rate variability and depression in children and adolescents - A meta-analytic update. J Affect Disord 2023; 339:237-255. [PMID: 37437729 DOI: 10.1016/j.jad.2023.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/09/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Depression is one of the most common mental disorders and a leading cause of disability worldwide. In adults, depression is characterized by decreased vagal activity (vagally-mediated heart rate variability; vmHRV), while vmHRV is inversely correlated with depressive symptoms. In children/adolescents, a 2016 synthesis (4 studies, 259 individuals) found similarly decreased vmHRV in clinical depression, but no significant association between depressive symptoms and vmHRV (6 studies, 2625 individuals). Given the small number of studies previously considered for synthesis and the rapidly growing evidence base in this area, a meta-analytic update was warranted. METHOD A previous review was updated by a systematic literature search to identify studies that (a) compared vmHRV in clinically depressed children/adolescents with non-depressed controls and (b) reported associations between vmHRV and depression severity. RESULTS The search update identified 5 additional studies for group comparison (k = 9 studies in total, n = 608 individuals in total) and 15 additional studies for correlational meta-analysis (k = 21 studies in total, n = 4224 individuals in total). Evidence was found for lower resting-state vmHRV in clinically depressed children/adolescents compared to healthy controls (SMD = -0.593, 95 % CI [-1.1760; -0.0101], I2 = 90.92 %) but not for a significant association between vmHRV and depressive symptoms (r = -0.053, 95 % CI [-0.118; 0.012], I2 = 65.77 %). Meta-regression revealed a significant association between depressive symptoms and vmHRV as a function of sex. LIMITATIONS The samples considered are highly heterogeneous. Data on the longitudinal association between vmHRV and depression are currently lacking. CONCLUSION The present findings support the use of vmHRV as a biomarker for clinical depression in children/adolescents.
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Affiliation(s)
- Luise Baumeister-Lingens
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Roxana Rothe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Lena Wolff
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Alexander L Gerlach
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Christine Sigrist
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany.
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Chen W, Zhong Q, Chen H, Chen S. Heart rate variability in children and adolescents with major depressive disorder: A systematic review and meta-analysis. J Affect Disord 2023; 335:204-215. [PMID: 37178829 DOI: 10.1016/j.jad.2023.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/23/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
Although reduced heart rate variability (HRV) has been observed in adults with major depressive disorder (MDD), the correlation between HRV and MDD in children and adolescents remains uncertain and requires to be systematically reviewed. Our meta-analysis included ten articles comprising 410 MDD patients and 409 healthy controls. Adolescents with MDD showed significant reductions in most HRV measures, such as HF-HRV, RMSSD, and PNN50, and depressive symptom severity was statistically associated with RMSSD, HF-HRV, and LF/HF ratio. A large heterogeneity across studies was detected. Sensitivity analysis revealed that removal of a specific study would significantly decline the heterogeneity for measures of HF-HRV, LF-HRV, and SDNN, and meta-regression analysis found that sample size and year of publication substantially moderated the differences between depressed samples and controls in RMSSD. Compared with adults, depression-induced autonomic dysfunction was more detectable in children and adolescents with substantial effects. Moreover, excluded studies which reported both HRV and MDD or depression symptoms were summarized based on objectives. Findings indicate that it is promising for HRV to be an appropriate and objective candidate biomarker for clinically depressed children and adolescents.
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Affiliation(s)
- Wanlin Chen
- Department of Psychological and Behavioral Science, Zhejiang University, No.866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
| | - Qing Zhong
- Department of Psychological and Behavioral Science, Zhejiang University, No.866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
| | - Hang Chen
- College of Biomedical Engineering and Instrument Science, Zhejiang University, No.38 Zheda Road, Hangzhou, Zhejiang 310027, China
| | - Shulin Chen
- Department of Psychological and Behavioral Science, Zhejiang University, No.866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China.
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Buchmann A, Ritter C, Müller ST, Haynes M, Ghisleni C, Tuura R, Hasler G. Associations between heart rate variability, peripheral inflammatory markers and major depressive disorder. J Affect Disord 2022; 304:93-101. [PMID: 35196535 DOI: 10.1016/j.jad.2022.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/31/2021] [Accepted: 02/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Measures for the irregularity of the heartbeat, for example respiratory sinus arrhythmia, have been implicated as a measure for restorative functions of the vegetative nervous system. METHODS In the current observational study, we investigated 265 subjects, 70 of whom had a lifetime history of major depression, with a plethysmographic heartbeat monitor, blood sampling, as well as a range of psychiatric questionnaires. RESULTS Subjects with a history of MDE had significantly reduced respiratory sinus arrhythmia (RSA) as compared to never-depressed controls; in the whole sample, higher RSA went with lower anxiety/fear variables, especially in subscores related to cardiac symptoms as well as being afraid of dying. A reduced RSA was also associated with an increased concentration of cytokines (TNFa, IL1a, IL6, IFNg) and thyroid-stimulating hormone in the serum, pointing to a possible triangular relationship between immune system, vegetative nervous system, and emotional dysregulation. LIMITATIONS We used a plethysmographic device for the measurement of heartbeat instead of an electrocardiogram, and had a single time point only. CONCLUSIONS This data corroborate the idea that a disequilibrium of the vegetative nervous, especially if accompanied by a dysregulation system in immune function, can increase the risk for depression. Conversely, vagal stimulation and anti-inflammatory treatments may support the treatment with antidepressants.
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Affiliation(s)
- Andreas Buchmann
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Fribourg, Switzerland; Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
| | - Christopher Ritter
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Fribourg, Switzerland; Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Sabrina Theresia Müller
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Melanie Haynes
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Carmen Ghisleni
- Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Ruth Tuura
- Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Gregor Hasler
- Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Fribourg, Switzerland
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Breath-by-breath analysis of respiratory sinus arrhythmia in dogs. Respir Physiol Neurobiol 2021; 294:103776. [PMID: 34407466 DOI: 10.1016/j.resp.2021.103776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/13/2021] [Accepted: 08/09/2021] [Indexed: 01/08/2023]
Abstract
Dogs differ greatly in size, heart (HR) and breathing rates (BR). In addition, they have a clear Respiratory Sinus Arrhythmia (RSA) at rest. Therefore, better than any other mammalian species, dogs offer an opportunity to test whether resting RSA varies with body weight, HR or BR. Sequences of inter-beat-intervals (IBI, ms) a few-minutes long were collected in twenty-three resting dogs of different sizes, together with pneumograms. IBI variability was quantified by standard time-domain criteria. From beat-to-beat instantaneous heart rate (hR, beats/min), RSA was the difference between inspiratory peak (hR-peak) and expiratory trough (hR-trough), in percent of mean HR. RSA averaged 40.1 % ±4.5, or more than three times that of humans, with large inter-animal variability. On average, RSA contributed 38 % of the total IBI variability. RSA did not differ between sexes and did not correlate with body weight. It had modest negative correlations with HR (P < 0.05) and BR (P < 0.05), and a very strong negative correlation with hR-trough (P < 0.001). In two separate dogs, during panting, RSA was absent. In the transition from resting to panting, RSA continued like at rest for several breaths, despite the tachypnea, underlying the importance of central mechanisms in the origin of RSA. In conclusion, RSA in dogs is very large and explains less than half of their sinus arrhythmia. Rather than HR, BR or hR-peak, changes in the vago-sympathetic control, represented by hR-trough, are the most likely source of variability of RSA among subjects.
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Scott BG, Fike EA, McCullen JR. Depressive symptoms among stress-exposed youth: Relations with tonic and phasic indices of autonomic functioning. Dev Psychobiol 2020; 63:1029-1042. [PMID: 33200408 DOI: 10.1002/dev.22056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/03/2020] [Accepted: 10/11/2020] [Indexed: 11/10/2022]
Abstract
Theoretical models of adolescent depression postulate that one possible individual vulnerability factor for the development of depressive symptoms is autonomic dysregulation. However, there is limited and mixed support for these models among ethnically diverse and higher risk stress-exposed youth. Therefore, this study investigated the relations between both tonic and phasic indices of parasympathetic autonomic functioning (i.e., resting high-frequency heart rate variability [HF-HRV] and root mean square of successive differences [RMSSD]; HF-HRV and RMSSD reactivity to a mental arithmetic stressor) and depressive symptoms among 80 severely stress-exposed youth (51% female; 11-17 years of age) from diverse backgrounds (61.3% ethnic minority; caregiver-reported median family income = $20,000-$49,999 per year). Results demonstrated that lower resting HF-HRV and RMSSD, but not HF-HRV and RMSSD reactivity, was associated with greater youth depressive symptoms. Our findings suggest that lower resting parasympathetic autonomic functioning may be a potential vulnerability factor of depressive symptoms among stress-exposed youth, instead of specific emotional responses to stressors. These findings will need to be replicated in larger samples of stress-exposed youth and youth at higher risk for or exhibiting clinical levels of depressive symptoms to better elucidate relations with autonomic functioning and depressive symptoms among adolescents.
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Gleichmann DC, Solis I, Janowich JR, Wang YP, Calhoun VD, Wilson TW, Stephen JM. Troubled Hearts: Association Between Heart Rate Variability and Depressive Symptoms in Healthy Children. Appl Psychophysiol Biofeedback 2020; 45:283-292. [PMID: 32978742 DOI: 10.1007/s10484-020-09488-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
Heart rate variability (HRV) captures the change in timing of consecutive heart beats and is reduced in individuals with depression and anxiety. The present study investigated whether typically-developing children without clinically recognized signs of depression or anxiety showed a relationship between HRV and depressive or anxiety symptoms. Children aged 9-14 years (N = 104) provided three minutes of cardiac signal during eyes closed rest and eyes open rest. The association between high frequency HRV, low frequency HRV, root mean square of the successive differences (RMSSD), and pNN20 versus depressive symptoms (NIH Toolbox and Child Behavior Checklist) was investigated. Results partially confirm our hypothesis, with pNN20 positively correlated with the self-reported depression measure of loneliness while controlling for age, sex, social status, and physical activity. The association was stronger in male participants. However, there is no consensus in the literature about which HRV measures are associated with depressive symptoms in healthy children. Additional studies are needed which reliably account for variables that influence HRV to establish whether certain HRV measures can be used as an early marker for depression risk in children.
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Affiliation(s)
| | - Isabel Solis
- The Mind Research Network, 1101 Yale Blvd NE, Albuquerque, NM, 87106, USA
| | | | - Yu-Ping Wang
- Tulane University, 6823 St. Charles Ave, New Orleans, LA, 70118, USA
| | - Vince D Calhoun
- The Mind Research Network, 1101 Yale Blvd NE, Albuquerque, NM, 87106, USA.,University of New Mexico, Albuquerque, NM, 87131, USA
| | - Tony W Wilson
- University of Nebraska Medical Center, S 42nd St. & Emile St, Omaha, NE, 68198, USA
| | - Julia M Stephen
- The Mind Research Network, 1101 Yale Blvd NE, Albuquerque, NM, 87106, USA.
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Mortola JP, Marghescu D, Siegrist-Johnstone R, Matthes E. Respiratory sinus arrhythmia during a mental attention task: the role of breathing-specific heart rate. Respir Physiol Neurobiol 2020; 272:103331. [DOI: 10.1016/j.resp.2019.103331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 11/26/2022]
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Mestanikova A, Mestanik M, Ondrejka I, Hrtanek I, Cesnekova D, Jurko A, Visnovcova Z, Sekaninova N, Tonhajzerova I. Complex cardiac vagal regulation to mental and physiological stress in adolescent major depression. J Affect Disord 2019; 249:234-241. [PMID: 30780116 DOI: 10.1016/j.jad.2019.01.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/22/2018] [Accepted: 01/22/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cardiovagal control is known to be reduced in major depressive disorder (MDD), however, the neurocardiac reflex control to distinct types of stressors is still unclear. We aimed to study parasympathetically mediated cardiac reflex functioning in response to mental and physiological stressors using heart rate variability (HRV) linear and nonlinear analysis in adolescent MDD. METHODS We examined 60 adolescents (40 girls) with MDD (age 14.9 ± 0.3 years) and 60 age and gender-matched controls. ECG was continuously recorded during stress protocol: baseline, Go/NoGo test, recovery, supine position, and orthostasis. Evaluated HRV linear and nonlinear indices: RR interval, pNN50, rMSSD, HF-HRV, Poincaré plot (SD1), symbolic dynamics 2UV%. Cardiovagal reactivity expressed as percentual change (%) was calculated in response to both stressors. RESULTS In each phase of stress protocol, the MDD group had significantly reduced HRV parameters compared to controls, except for symbolic dynamics index 2UV% in supine position. The reactivity of HRV indices was significantly greater in response to orthostasis in MDD compared to controls. No significant differences were found in response to Go/NoGo test. LIMITATIONS The smoking status and the menstrual cycle phase potentially affecting the HRV parameters were not monitored. Future research is needed to expand a sample size with respect to sex and to study neurocardiac response to other different stressors in MDD. CONCLUSIONS This study revealed reduced resting cardiovagal regulation and greater vagal withdrawal indicating abnormal neurocardiac reflex functioning to physiological stressor (orthostasis) in adolescent MDD patients. Nonlinear HRV analysis was sensitive to detect cardiac-linked regulatory differences in adolescent depression.
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Affiliation(s)
- Andrea Mestanikova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Michal Mestanik
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Dana Cesnekova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Alexander Jurko
- Pediatric Cardiology, Kollarova 13, 036 01 Martin, Slovak Republic.
| | - Zuzana Visnovcova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Nikola Sekaninova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Ingrid Tonhajzerova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
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Vloet TD, Jans T, Frey A, Häußler M, Vloet A, Geissler J, Susewind M, von Dobschütz B, Frantz S, Romanos M. Mean Heart Rate and Parameters of Heart Rate Variability in Depressive Children and the Effects of Antidepressant Medication. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2019; 47:253-260. [PMID: 30971175 DOI: 10.1024/1422-4917/a000672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Introduction: Researchers have repeatedly discovered an association between depression and autonomic cardiac dysregulation in adults. However, corresponding data concerning minors are still rare. Method: For this exploratory, cross-sectional study, we included N = 43 minors (age range 9-17 years). The subjects were depressive subjects with or without antidepressant medication (N = 23) or healthy control children (HC) (N = 20). We assessed several indices of cardiac functioning using long-term electrocardiogram data (mean heart rate, HR, and several parameters of heart rate variability, HRV). We hypothesized that increased HR and reduced HRV are associated with depressive disorders. Furthermore, we assessed the impact of age, sex, and antidepressant medication on HR and HRV. Results: When sex and age were controlled for, HR was significantly increased in depressive minors compared to HC. However, our preliminary data suggest that this might not be the case in medicated patients, and there were no differences between groups regarding HRV parameters. There was no significant correlation in the whole sample between severity of depression and both HR and HRV. In the subsample of patients with depression, antidepressant medication was associated with lower HR and higher indices of HRV. Conclusion: The data indicate an association between depression and altered autonomic cardiac regulation, which can already manifests in minors.
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Affiliation(s)
- Timo D Vloet
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany.,a First authors
| | - Thomas Jans
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany.,a First authors
| | - Anna Frey
- 2 Department of Internal Medicine I, University Hospital, Würzburg, Germany
| | - Marie Häußler
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Andrea Vloet
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Julia Geissler
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Moritz Susewind
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | | | - Stefan Frantz
- 2 Department of Internal Medicine I, University Hospital, Würzburg, Germany
| | - Marcel Romanos
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
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Park SW, Lee JH, Kim J, Suh S, Lee MS. Changes in heart rate variability in first-episode drug-naïve adolescents with major depressive disorder: A 12-week prospective study. J Affect Disord 2018; 238:250-255. [PMID: 29890452 DOI: 10.1016/j.jad.2018.05.068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/30/2018] [Accepted: 05/28/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a common mental disorder, the onset of which frequently occurs during adolescence. While differences in heart rate variability (HRV) between depressed and healthy participants have previously been observed, results have been inconsistent. This study thus investigated the features of HRV in adolescents with MDD. METHODS We recruited first-episode drug-naïve adolescents aged 13-18 years who had been diagnosed with MDD, and healthy age-matched controls. HRV was measured before and after a 12-week antidepressant treatment. We compared HRV measures between patient group and control group. We also tried to find correlation between HRV measures and depression rating scales. RESULTS Fifty-seven participants were included (patient group: n = 31; control group: n = 26). The patient group showed a lower normalized high frequency (HF norm), a higher normalized low frequency (LF norm), and a higher LF/HF ratio than did the control group. After treatment, LF was significantly decreased within the patient group compared to baseline. Hamilton Depression Rating Scales and Children's Depression Inventory scores were positively correlated with LF norm and LF/HF ratio, and negatively correlated with HF norm, when included all participants in analysis LIMITATIONS: Sample size of this study was small to assess influences of confounding factors on HRV. And follow up period was relatively short to see impact of pharmacotherapy. CONCLUSION An imbalance of the autonomic nervous system might be a meaningful feature of adolescent MDD, and HRV might represent a potential biological marker for pathophysiological changes in MDD.
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Affiliation(s)
- Sang-Won Park
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, College of Medicine, Korea University, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea
| | - Jong-Ha Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, College of Medicine, Korea University, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea
| | - Jihyun Kim
- Department of Neurology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sangil Suh
- Department of Radiology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Moon-Soo Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, College of Medicine, Korea University, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea.
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Mestanikova A, Ondrejka I, Mestanik M, Cesnekova D, Visnovcova Z, Bujnakova I, Oppa M, Calkovska A, Tonhajzerova I. Pupillary light reflex is altered in adolescent depression. Physiol Res 2018; 66:S277-S284. [PMID: 28937242 DOI: 10.33549/physiolres.933683] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Major depressive disorder is associated with abnormal autonomic regulation which could be noninvasively studied using pupillometry. However, the studies in adolescent patients are rare. Therefore, we aimed to study the pupillary light reflex (PLR), which could provide novel important information about dynamic balance between sympathetic and parasympathetic nervous system in adolescent patients suffering from major depression. We have examined 25 depressive adolescent girls (age 15.2+/-0.3 year) prior to pharmacotherapy and 25 age/gender-matched healthy subjects. PLR parameters were measured separately for both eyes after 5 min of rest using Pupillometer PLR-2000 (NeurOptics, USA). The constriction percentual change for the left eye was significantly lower in depressive group compared to control group (-24.12+/-0.87 % vs. -28.04+/-0.96 %, p<0.01). Furthermore, average constriction velocity and maximum constriction velocity for the left eye were significantly lower in depressive group compared to control group (p<0.05, p<0.01, respectively). In contrast, no significant between-groups differences were found for the right eye. Concluding, this study revealed altered PLR for left eye indicating a deficient parasympathetic activity already in adolescent major depression. Additionally, the differences between left and right eye could be related to functional lateralization of autonomic control in the central nervous system.
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Affiliation(s)
- A Mestanikova
- Department of Physiology and Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia. or
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Respiratory sinus arrhythmia in the immediate post-exercise period: correlation with breathing-specific heart rate. Eur J Appl Physiol 2018; 118:1397-1406. [DOI: 10.1007/s00421-018-3871-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
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14
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Kotianova A, Kotian M, Slepecky M, Chupacova M, Prasko J, Tonhajzerova I. The differences between patients with panic disorder and healthy controls in psychophysiological stress profile. Neuropsychiatr Dis Treat 2018; 14:435-441. [PMID: 29445280 PMCID: PMC5808685 DOI: 10.2147/ndt.s153005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Alarming somatic symptoms, in particular, cardiovascular symptoms, are the characteristic feature of panic attacks. Increased cardiac mortality and morbidity have been found in these patients. Power spectral analysis of electrocardiogram R-R intervals is known to be a particularly successful tool in the detection of autonomic instabilities in various clinical disorders. Our study aimed to compare patients with panic disorder and healthy controls in heart rate variation (HRV) parameters (very-low-frequency [VLF], low-frequency [LF], and high-frequency [HF] band components of R-R interval) in baseline and during the response to the mental task. SUBJECTS AND METHODS We assessed psychophysiological variables in 33 patients with panic disorder (10 men, 23 women; mean age 35.9±10.7 years) and 33 age- and gender-matched healthy controls (10 men, 23 women; mean age 35.8±12.1 years). Patients were treatment naïve. Heart rate, blood pressure, muscle tension, and HRV in basal conditions and after the psychological task were assessed. Power spectrum was computed for VLF (0.003-0.04 Hz), LF (0.04-0.15 Hz), and HF (0.15-0.40 Hz) bands using fast Fourier transformation. RESULTS In the baseline period, the VLF band was significantly lower in panic disorder group compared to controls (p<0.005). In the period of mental task, the LF/HF ratio was significantly higher in panic disorder patients compared to controls (p<0.05). No significant differences were found in the remaining parameters. There was a significant difference in ΔHF and ΔLF/HF ratio between patients and controls, with Δ increasing in patients and decreasing in controls. CONCLUSION These findings revealed that patients suffering from panic disorder were characterized by relative sympathetic dominance (reactivity) in response to mental stress compared with healthy controls.
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Affiliation(s)
- Antonia Kotianova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic.,Psychagogia, Garbiarska, Liptovsky Mikulas, Slovak Republic
| | - Michal Kotian
- Psychagogia, Garbiarska, Liptovsky Mikulas, Slovak Republic
| | - Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic.,Psychagogia, Garbiarska, Liptovsky Mikulas, Slovak Republic
| | | | - Jan Prasko
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic.,Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, Czech Republic
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.,Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
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Clinical and non-clinical depression and anxiety in young people: A scoping review on heart rate variability. Auton Neurosci 2017; 208:1-14. [DOI: 10.1016/j.autneu.2017.08.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 05/26/2017] [Accepted: 08/22/2017] [Indexed: 11/24/2022]
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Autonomic function testing: Compliance and consequences. Auton Neurosci 2017; 208:150-155. [PMID: 29107740 DOI: 10.1016/j.autneu.2017.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 08/17/2017] [Accepted: 10/13/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND The deep breathing test (DB) and Valsalva maneuver (VM) are used to detect autonomic dysfunction. The VM induces sympathetically mediated changes in blood pressure (phase II late, phase IV, and recovery time) and both tests induce vagally mediated heart rate changes. There is limited information on effects of key variables, compliance with testing and the effects of non-compliance This study has twin goals of evaluating compliance with standard instructions and the effects of changes in key variables. We also evaluated the effect of position on the VM. MATERIAL AND METHODS Forty healthy males performed DB at air exchange volumes of 50, 80, and 100% of vital lung capacity (VLC). The VM was performed at 40 and 30mmHg expiratory pressure for 15 and 10s in sitting and supine position, respectively. RESULTS Participants performed DB at lower volumes than intended and were not able to maintain 100% VLC for the duration of the test. The DB heart rate response decreased 6.3beats/min per liter below VLC. During the VM, subjects blew at lower pressures than instructed. The VM responses were significantly larger with longer expiration durations, higher expiratory pressures and when performed sitting. Performing the VM at 40mmHg for 10s in supine position increased the odds ratio of experiencing flat-top responses. CONCLUSION The ability of subjects to strictly comply with methodological guidelines significantly improves results. Recording of both test parameters and ensuing results is suggested.
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Stange JP, Alloy LB, Fresco DM. Inflexibility as a Vulnerability to Depression: A Systematic Qualitative Review. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2017; 24:245-276. [PMID: 29038622 PMCID: PMC5640320 DOI: 10.1111/cpsp.12201] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The study of vulnerabilities to depression typically identifies factors that are thought to be universally maladaptive or adaptive. In contrast, researchers recently have theorized that the ability to flexibly engage in different thoughts and behaviors that fit situational demands may be most indicative of psychological health. We review empirical evidence from 147 studies reporting associations between five components of flexibility (set-shifting, affective set-shifting, cardiac vagal control, explanatory flexibility, and coping flexibility) and depression and classify studies according to strength of study design. Evidence from correlational and case-controlled studies suggests cross-sectional relationships, but few prospective studies have been conducted. We discuss limitations of existing studies, identify new directions for programmatic research, and discuss implications that flexibility has for the prevention and treatment of depression.
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Kovacs M, Yaroslavsky I, Rottenberg J, George CJ, Kiss E, Halas K, Dochnal R, Benák I, Baji I, Vetró A, Makai A, Kapornai K. Maladaptive mood repair, atypical respiratory sinus arrhythmia, and risk of a recurrent major depressive episode among adolescents with prior major depression. Psychol Med 2016; 46:2109-2119. [PMID: 27198823 DOI: 10.1017/s003329171600057x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Because depressive illness is recurrent, recurrence prevention should be a mainstay for reducing its burden on society. One way to reach this goal is to identify malleable risk factors. The ability to attenuate sadness/dysphoria (mood repair) and parasympathetic nervous system functioning, indexed as respiratory sinus arrhythmia (RSA), are impaired during depression and after it has remitted. The present study therefore tested the hypothesis that these two constructs also may mirror risk factors for a recurrent major depressive episode (MDE). METHOD At time 1 (T1), 178 adolescents, whose last MDE had remitted, and their parents, reported on depression and mood repair; youths' RSA at rest and in response to sad mood induction also were assessed. MDE recurrence was monitored until time 2 (T2) up to 2 years later. Mood repair at T1 (modeled as a latent construct), and resting RSA and RSA response to sadness induction (RSA profile), served to predict onset of first recurrent MDE by T2. RESULTS Consistent with expectations, maladaptive mood repair predicted recurrent MDE, above and beyond T1 depression symptoms. Further, atypical RSA profiles at T1 were associated with high levels of maladaptive mood repair, which, in turn, predicted increased risk of recurrent MDE. Thus, maladaptive mood repair mediated the effects of atypical RSA on risk of MDE recurrence. CONCLUSIONS This study documented that a combination of behavioral and physiological risk factors predicted MDE recurrence in a previously clinically referred sample of adolescents with depression histories. Because mood repair and RSA are malleable, both could be targeted for modification to reduce the risk of recurrent depression in youths.
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Affiliation(s)
- M Kovacs
- University of Pittsburgh School of Medicine,Pittsburgh, PA,USA
| | | | | | - C J George
- University of Pittsburgh Medical Center,PA,USA
| | - E Kiss
- Szeged University,Hungary
| | | | | | | | - I Baji
- Szeged University,Hungary
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Depression and resting state heart rate variability in children and adolescents — A systematic review and meta-analysis. Clin Psychol Rev 2016; 46:136-50. [DOI: 10.1016/j.cpr.2016.04.013] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 04/18/2016] [Accepted: 04/23/2016] [Indexed: 12/13/2022]
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Mestanikova A, Ondrejka I, Mestanik M, Hrtanek I, Snircova E, Tonhajzerova I. Electrodermal Activity in Adolescent Depression. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 935:83-8. [DOI: 10.1007/5584_2016_40] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Mortola JP, Marghescu D, Siegrist-Johnstone R. Thinking about breathing: Effects on respiratory sinus arrhythmia. Respir Physiol Neurobiol 2015; 223:28-36. [PMID: 26724603 DOI: 10.1016/j.resp.2015.12.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 11/06/2015] [Accepted: 12/16/2015] [Indexed: 11/29/2022]
Abstract
Respiratory sinus arrhythmia (RSA), the increase and decrease in instantaneous heart rate (HR) with inspiration and expiration, is commonly evaluated as function of breathing frequency f. However, to the extent that RSA plays a role in the efficiency of gas exchange, it may be expected to correlate better with HR/f ('breathing specific heart rate') than with f, because the former is a better reflection of the cardio-respiratory coupling. We measured RSA breath-by-breath in 209 young men and women during spontaneous breathing and during volitional breathing under auditory cues at vastly different f. In either case, and for both genders, RSA correlated better with HR/f than with f. As HR/f increased so did RSA, in a linear manner. When compared on the basis of HR/f, RSA did not differ significantly between spontaneous and volitional breathing. It is proposed that RSA is a central mechanism that ameliorates the matching between the quasi-continuous pulmonary blood flow and the intermittent airflow, irrespective of the type of ventilatory drive (cortical or autonomic).
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Affiliation(s)
- Jacopo P Mortola
- Department of Physiology, McGill University, Montreal, QC, Canada.
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Blood JD, Wu J, Chaplin TM, Hommer R, Vazquez L, Rutherford HJV, Mayes LC, Crowley MJ. The variable heart: High frequency and very low frequency correlates of depressive symptoms in children and adolescents. J Affect Disord 2015; 186:119-26. [PMID: 26233322 PMCID: PMC4565756 DOI: 10.1016/j.jad.2015.06.057] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/17/2015] [Accepted: 06/20/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Work examining the link between lower heart rate variability (HRV) and depression in children and adolescents is lacking, especially in light of the physiological changes that occur during pubertal development. METHOD We investigated the association between spectral measures of resting HRV and depressive symptoms among 127 children and adolescents, ages 10-17. Using spectral analysis, we evaluated (1) the association between relative high frequency (HF) HRV and depressive symptoms; (2) the predictive power of relative HF HRV for depressive symptoms in the context of relative low frequency (LF) and relative very low frequency (VLF) HRV; and (3) the relationship between relative HF, LF, and VLF band activity, age and pubertal maturation. RESULTS Consistent with previous work, results revealed that relative HF HRV was negatively associated with self-reported depressive symptoms. As well, relative VLF HRV was positively associated with depressive symptoms. Regression analyses revealed that relative HF HRV and relative VLF HRV significantly predicted self-report depressive symptoms while controlling for age, sex and pubertal maturation, with relative VLF HRV emerging as the strongest indicator of depressive symptoms. Developmental findings also emerged. Age and pubertal maturation were negatively associated with relative HF HRV and positively correlated with relative VLF HRV. CONCLUSIONS Results provide support for the relationship between HRV and depression and suggest that both HF and VLF HRV are relevant to depression symptom severity. Findings also reinforce the importance of considering pubertal development when investigating HRV-depression associations in children and adolescents. LIMITATIONS Influences on cardiac control including physical activity levels and exercise patterns could be controlled in future work. Our data speak to a depressive symptom dimension and relative spectral power HRV. Thus, we cannot make strong claims about relative spectral power HRV and clinical depression.
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Affiliation(s)
- Julia D Blood
- School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - Jia Wu
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA; Developmental Electrophysiology Laboratory, Yale Child Study Center, New Haven, CT, USA
| | - Tara M Chaplin
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Rebecca Hommer
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Lauren Vazquez
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Helena J V Rutherford
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA; Developmental Electrophysiology Laboratory, Yale Child Study Center, New Haven, CT, USA
| | - Linda C Mayes
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA; Developmental Electrophysiology Laboratory, Yale Child Study Center, New Haven, CT, USA
| | - Michael J Crowley
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA; Program for Anxiety Disorders, Yale Child Study Center, New Haven, CT, USA; Developmental Electrophysiology Laboratory, Yale Child Study Center, New Haven, CT, USA; Center for Translational Developmental Neuroscience, Yale Child Study Center, New Haven, CT, USA.
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Respiratory sinus arrhythmia in young men and women at different chest wall configurations. Clin Sci (Lond) 2015; 128:507-16. [PMID: 25387977 DOI: 10.1042/cs20140543] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Respiratory sinus arrhythmia (RSA) is an acceleration of heart rate during inspiration and deceleration with expiration. We asked whether or not in humans some of the volume-related information necessary for RSA originated from the chest wall. Men and women, 19-20 years old, were breathing supine. Rib cage and abdomen displacement provided an index of tidal volume (VT) and RSA was computed breath-by-breath from the peak and trough of instantaneous heart rate. First, measurements were taken during breathing at rest (protocol a, 129 male and 164 female). Then, in subgroups of the original subject population, measurements were collected for the first five breaths immediately following a brief breath-hold period (protocol b), predominantly with the rib cage or predominantly with the abdomen (protocol c), above functional residual capacity or below it (protocol d). As long as VT was constant, severe chest wall distortion (protocol c) did not modify RSA. A drop in absolute lung volume (protocol d) or an increase in VT (protocol b) respectively decreased and increased RSA. The results, globally taken, are compatible with the notion that in humans changes in lung volume are detected by lung mechanoreceptors, whereas chest wall reflexes play no role in RSA. No difference in RSA emerged between genders during resting breathing or modest breath-hold hyperventilation.
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Feng J, Wang A, Gao C, Zhang J, Chen Z, Hou L, Luo C, Jiang Y, Pan J. Altered heart rate variability depend on the characteristics of coronary lesions in stable angina pectoris. Anatol J Cardiol 2014; 15:496-501. [PMID: 25550177 PMCID: PMC5779144 DOI: 10.5152/akd.2014.5642] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Dysfunction of cardiac autonomic nerve system is considered as one of risk factors for coronary atherosclerotic heart disease. Heart rate variability (HRV) has been used to study the correlation between damage of coronary artery and dysfunction of autonomic nervous system. We hypothesize the correlation between damage of coronary artery and dysfunction of autonomic nervous system by HRV among subjects with stable angina. METHODS A 236 subjects who diagnosed as stable angina pectoris by elective coronary angiography, were divided into two groups by Gensini score system (GS):GS≤32 (GS1) and GS2>32 (GS2). Subgroups were divided based on location of stenosis lesions and the number of coronary artery disease. 86 subjects suspicious with stable angina pectoris with normal coronary angiography were selected as the control group. All subjects were received 24-hour ambulatory electrocardiogram and the result of time-domain HRV was analyzed (SDNN, SDANN, SDNNind, RMSSD, PNN50). RESULTS Compared with control group, SDNN, SDNNind and RMSSD lower in GS1, and SDNN, SDANN, SDNNind, RMSSD, PNN50 lower in GS2; ccompared with GS1, SDNN was lower in GS2. Compared with control group, SDNN in one-vessel, SDNN, SDANN in two-vessel diseased and in three-vessel diseased were lower, and compared with two-vessel diseased, SDNN, SDANN lower in three-vessel diseased. Compared with right-coronary artery diseased, SDNN and SDANN in left-coronary artery diseased group were lower, while compared with lesions in left circumflex, SDNN in lesions in left anterior descending artery lower. CONCLUSION HRV may be play a crucial role in estimating the correlation between damage of coronary artery and dysfunction of autonomic nerve system.
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Affiliation(s)
- Jun Feng
- Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei); Hefei Anhui Province-China.
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Pivatelli FC, dos Santos MA, Fernandes GB, Gatti M, de Abreu LC, Valenti VE, Vanderlei LCM, Ferreira C, Adami F, de Carvalho TD, Monteiro CBDM, de Godoy MF. Sensitivity, specificity and predictive values of linear and nonlinear indices of heart rate variability in stable angina patients. Int Arch Med 2012; 5:31. [PMID: 23110977 PMCID: PMC3549885 DOI: 10.1186/1755-7682-5-31] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 10/16/2012] [Indexed: 11/14/2022] Open
Abstract
UNLABELLED BACKGROUND Decreased heart rate variability (HRV) is related to higher morbidity and mortality. In this study we evaluated the linear and nonlinear indices of the HRV in stable angina patients submitted to coronary angiography. METHODS We studied 77 unselected patients for elective coronary angiography, which were divided into two groups: coronary artery disease (CAD) and non-CAD groups. For analysis of HRV indices, HRV was recorded beat by beat with the volunteers in the supine position for 40 minutes. We analyzed the linear indices in the time (SDNN [standard deviation of normal to normal], NN50 [total number of adjacent RR intervals with a difference of duration greater than 50ms] and RMSSD [root-mean square of differences]) and frequency domains ultra-low frequency (ULF) ≤ 0,003 Hz, very low frequency (VLF) 0,003 - 0,04 Hz, low frequency (LF) (0.04-0.15 Hz), and high frequency (HF) (0.15-0.40 Hz) as well as the ratio between LF and HF components (LF/HF). In relation to the nonlinear indices we evaluated SD1, SD2, SD1/SD2, approximate entropy (-ApEn), α1, α2, Lyapunov Exponent, Hurst Exponent, autocorrelation and dimension correlation. The definition of the cutoff point of the variables for predictive tests was obtained by the Receiver Operating Characteristic curve (ROC). The area under the ROC curve was calculated by the extended trapezoidal rule, assuming as relevant areas under the curve ≥ 0.650. RESULTS Coronary arterial disease patients presented reduced values of SDNN, RMSSD, NN50, HF, SD1, SD2 and -ApEn. HF ≤ 66 ms2, RMSSD ≤ 23.9 ms, ApEn ≤-0.296 and NN50 ≤ 16 presented the best discriminatory power for the presence of significant coronary obstruction. CONCLUSION We suggest the use of Heart Rate Variability Analysis in linear and nonlinear domains, for prognostic purposes in patients with stable angina pectoris, in view of their overall impairment.
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Affiliation(s)
- Flávio Correa Pivatelli
- Serviço de Hemodinâmica e Cardiologia Intervencionista do Hospital de Base – Fundação Faculdade Regional de Medicina (FUNFARME), de São José do Rio Preto (SP) and Departamento de Cardiologia e Cirurgia Cardiovascular da Faculdade de Medicina de São José do Rio Preto (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
- NUTECC – Núcleo Transdisciplinar para Estudo do Caos e da Complexidade (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
| | - Marcio Antonio dos Santos
- Serviço de Hemodinâmica e Cardiologia Intervencionista do Hospital de Base – Fundação Faculdade Regional de Medicina (FUNFARME), de São José do Rio Preto (SP) and Departamento de Cardiologia e Cirurgia Cardiovascular da Faculdade de Medicina de São José do Rio Preto (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
- NUTECC – Núcleo Transdisciplinar para Estudo do Caos e da Complexidade (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
| | - Gislaine Buzzini Fernandes
- Departamento de Enfermagem em Saúde Coletiva e Orientação Profissional (DESCOP) do Curso de Enfermagem da Faculdade de Medicina de São José do Rio Preto (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
- NUTECC – Núcleo Transdisciplinar para Estudo do Caos e da Complexidade (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
| | - Marcio Gatti
- Departamento de Especialidades Cirúrgicas da Faculdade de Medicina de São José do Rio Preto (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
- NUTECC – Núcleo Transdisciplinar para Estudo do Caos e da Complexidade (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
| | - Luiz Carlos de Abreu
- Laboratório de Escrita Científica, Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brazil
| | - Vitor E Valenti
- Programa de Pós-Graduação em Fisioterapia, Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista, UNESP, Rua Roberto Simonsen, 305, 19060-900, Presidente Prudente, SP, Brazil
| | - Luiz Carlos M Vanderlei
- Programa de Pós-Graduação em Fisioterapia, Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista, UNESP, Rua Roberto Simonsen, 305, 19060-900, Presidente Prudente, SP, Brazil
| | - Celso Ferreira
- Laboratório de Escrita Científica, Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brazil
| | - Fernando Adami
- Laboratório de Escrita Científica, Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brazil
| | - Tatiana Dias de Carvalho
- Laboratório de Escrita Científica, Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brazil
| | - Carlos Bandeira de Mello Monteiro
- Laboratório de Escrita Científica, Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brazil
| | - Moacir Fernandes de Godoy
- Serviço de Hemodinâmica e Cardiologia Intervencionista do Hospital de Base – Fundação Faculdade Regional de Medicina (FUNFARME), de São José do Rio Preto (SP) and Departamento de Cardiologia e Cirurgia Cardiovascular da Faculdade de Medicina de São José do Rio Preto (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
- NUTECC – Núcleo Transdisciplinar para Estudo do Caos e da Complexidade (FAMERP), Av. Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil
- Rua Garabed Karabashian 570, 15070-600, São José do Rio Preto, SP, Brazil
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Tonhajzerova I, Ondrejka I, Chladekova L, Farsky I, Visnovcova Z, Calkovska A, Jurko A, Javorka M. Heart rate time irreversibility is impaired in adolescent major depression. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:212-7. [PMID: 22771778 DOI: 10.1016/j.pnpbp.2012.06.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 06/15/2012] [Accepted: 06/29/2012] [Indexed: 01/26/2023]
Abstract
UNLABELLED We aimed to study heart rate time irreversibility--a nonlinear qualitative characteristics of heart rate variability indicating complexity of cardiac autonomic control at rest and in response to physiological stress (orthostasis) in never-treated major depressive disorder (MDD) adolescent female patients. METHODS We studied 20 MDD girls and 20 healthy age-matched girls at the age of 15 to 18 years. The ECG was recorded in supine position and in response to position change from lying to standing (orthostasis). Time irreversibility analysis was performed using Porta's (P%), Guzik's (G%) and Ehlers' (E) index. The depressive disorder severity was evaluated using Montgomery-Asberg Depression Rating Scale (MADRS) and Children's Depression Inventory (CDI). RESULTS Resting heart rate time irreversibility indices (logG%, logP%, Ehlers' index) were significantly reduced in MDD female patients without significant differences in response to orthostasis in MDD girls compared to controls. No significant correlations between time irreversibility and MDD severity were observed. CONCLUSION This study revealed the impaired heart rate asymmetry pattern indicating an altered complexity of cardiac autonomic regulation in adolescent female patients suffering from MDD.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
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Henje Blom E, Lekander M, Ingvar M, Åsberg M, Mobarrez F, Serlachius E. Pro-inflammatory cytokines are elevated in adolescent females with emotional disorders not treated with SSRIs. J Affect Disord 2012; 136:716-23. [PMID: 22056230 DOI: 10.1016/j.jad.2011.10.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 10/03/2011] [Accepted: 10/03/2011] [Indexed: 12/23/2022]
Abstract
BACKGROUND Adults with major depressive disorder (MDD) show elevated levels of IL-6 and TNF-alpha. Studies of adolescents with MDD or anxiety disorders (AD) are few and present conflicting results. METHODS We studied plasma cytokines in a clinical sample of adolescent females with MDD and/or clinical AD (n=60, mean age 16.8 years), compared to healthy controls (n=44; mean age 16.5 years). RESULTS The clinical sample showed significantly higher values of IL-2 (Z=-4.09, p>0.0001), IL1-beta (Z=-2.40, p<0.05) and IL-10 (Z=-2.38, p<0.05) as compared to controls. The subgroup of the clinical sample not treated with SSRIs had a significant difference of IL-6 (Z=-2.26, p<0.05) in addition to the difference of IL-2 and IL1-beta, but showed no difference of IL-10 as compared to the controls. SSRI treatment was related to IL-6, explaining 26% of the variance in the clinical sample after controlling for BMI and symptom severity. In the clinical sample, levels of IL-6 and IFN-gamma were positively correlated with self-assessed symptoms of anxiety and/or depression (corr.coeff 0.35 resp 0.40 at p<0.05). LIMITATIONS The cross-sectional design does not allow for conclusions on causality. The sample sizes were relatively small and a large drop-out in the clinical sample may have influenced the representativity. DISCUSSION The study suggests that pro-inflammatory cytokines are part of the pathophysiology of emotional disorders in adolescent females and that SSRIs have anti-inflammatory properties. The findings prompt further studies on the specific mechanisms involved and may contribute to the development of more effective treatment and prevention.
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Affiliation(s)
- Eva Henje Blom
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
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