Short-term heart rate variability in older patients with newly diagnosed depression

Dysfunction of the autonomic nervous system has been considered to be a risk factor for major depressive disorder (MDD) and cardiovascular disease (CVD). The aim of this study was to evaluate short-term heart rate variability (HRV) in elderly patients with newly diagnosed MDD. Thirty MDD patients over 60 years old newly diagnosed by a structured interview were enrolled, free from antidepressants. Socio-demographic data, blood tests, and heart rate variability (HRV) obtained from 5-min ECG were gathered. The MDD group showed significantly lower very low frequency power, low frequency power, high frequency power, and total power in frequency domain. In time domain analysis, the MDD group showed a significantly smaller standard deviation of the NN, root mean square of the differences of the successive NN, and NN50/total number of all NNs. These findings demonstrated a lower HRV in older patients who were newly diagnosed with depression without a history of CVD and antidepressants effect, compared with the control subjects. Low HRV may be an important predictor of both MDD and CVD in elderly. The use of HRV in elderly depressive patients could be a meaningful screening method for risk of CVD.

[1]  T. Vos,et al.  Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010 , 2013, The Lancet.

[2]  H. Rusko,et al.  Intraindividual validation of heart rate variability indexes to measure vagal effects on hearts. , 2006, American journal of physiology. Heart and circulatory physiology.

[3]  K. Krishnan,et al.  Depression in patients with coronary artery disease. , 1996, Depression.

[4]  A. Folsom,et al.  Low Heart Rate Variability in a 2-Minute Rhythm Strip Predicts Risk of Coronary Heart Disease and Mortality From Several Causes: The ARIC Study , 2000, Circulation.

[5]  Kenneth E Freedland,et al.  Depression, the Autonomic Nervous System, and Coronary Heart Disease , 2005, Psychosomatic medicine.

[6]  F. Zitman,et al.  Association between major depressive disorder and heart rate variability in the Netherlands Study of Depression and Anxiety (NESDA). , 2008, Archives of general psychiatry.

[7]  L. Mulder,et al.  The utility of low frequency heart rate variability as an index of sympathetic cardiac tone: a review with emphasis on a reanalysis of previous studies. , 2013, Psychophysiology.

[8]  C. Nemeroff,et al.  Heartache and heartbreak—the link between depression and cardiovascular disease , 2012, Nature Reviews Cardiology.

[9]  Ellen Frank,et al.  Major depressive disorder: new clinical, neurobiological, and treatment perspectives , 2012, The Lancet.

[10]  J. Thayer,et al.  Neurovisceral integration in cardiac and emotional regulation , 2002, IEEE Engineering in Medicine and Biology Magazine.

[11]  Daniel S Quintana,et al.  The relationship between mental and physical health: insights from the study of heart rate variability. , 2013, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[12]  G. Lloyd Textbook of Psychosomatic Medicine , 2006, British Journal of Psychiatry.

[13]  A. Johnson,et al.  Biological mechanisms in the relationship between depression and heart disease , 2002, Neuroscience & Biobehavioral Reviews.

[14]  C. Finucane,et al.  Antidepressants strongly influence the relationship between depression and heart rate variability: findings from The Irish Longitudinal Study on Ageing (TILDA) , 2014, Psychological Medicine.

[15]  R. Hughson,et al.  Physical activity is a major contributor to the ultra low frequency components of heart rate variability , 1999, Heart.

[16]  A. Timmis,et al.  Relation between heart rate variability early after acute myocardial infarction and long-term mortality. , 1994, The American journal of cardiology.

[17]  P. Sienaert,et al.  Metabolic syndrome and metabolic abnormalities in patients with major depressive disorder: a meta-analysis of prevalences and moderating variables , 2013, Psychological Medicine.

[18]  Alan J. Thomas,et al.  A study of orthostatic hypotension, heart rate variability and baroreflex sensitivity in late-life depression. , 2011, Journal of affective disorders.

[19]  V. Preedy,et al.  National Health and Nutrition Examination Survey , 2010 .

[20]  J. Shaw,et al.  Metabolic syndrome—a new world‐wide definition. A Consensus Statement from the International Diabetes Federation , 2006, Diabetic medicine : a journal of the British Diabetic Association.

[21]  B. Wiese,et al.  Age- and gender-specific prevalence of depression in latest-life--systematic review and meta-analysis. , 2012, Journal of affective disorders.

[22]  Rick Martinez,et al.  Comorbidity of late life depression: an opportunity for research on mechanisms and treatment , 2002, Biological Psychiatry.

[23]  D Sapoznikov,et al.  Five minute recordings of heart rate variability for population studies: repeatability and age–sex characteristics , 1998, Heart.

[24]  J. Mota,et al.  Metabolic syndrome, physical activity and cardiac autonomic function , 2012, Diabetes/metabolism research and reviews.

[25]  R. Carney,et al.  Depression as a risk factor for cardiac mortality and morbidity: a review of potential mechanisms. , 2002, Journal of psychosomatic research.

[26]  Kiyoshi Kawakubo,et al.  Assessment of the primary effect of aging on heart rate variability in humans , 2000, Clinical Autonomic Research.

[27]  Paul Zimmet,et al.  The metabolic syndrome—a new worldwide definition , 2005, The Lancet.

[28]  Jonathan Rottenberg,et al.  Cardiac vagal control in depression: A critical analysis , 2007, Biological Psychology.

[29]  Neurobiology of depression and reduced heart rate variability in coronary artery disease. , 1996, The American journal of cardiology.

[30]  C. Taylor,et al.  Depression, heart rate related variables and cardiovascular disease. , 2010, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[31]  R. Rugulies Depression as a predictor for coronary heart disease. a review and meta-analysis. , 2002, American journal of preventive medicine.

[32]  H. Krumholz,et al.  Depression and Risk of Heart Failure Among the Elderly: A Prospective Community-Based Study , 2002, Psychosomatic medicine.

[33]  D. Mcleod,et al.  Major depression and cardiac autonomic control , 1997, Biological Psychiatry.

[34]  J. Bigger,et al.  Cardiovascular Health and Depression , 2003, Journal of psychiatric practice.

[35]  M. Thase,et al.  Heart rate variability in depressed elderly. , 2008, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[36]  J. Halter,et al.  Sympathetic nervous system activity in major depression. Basal and desipramine-induced alterations in plasma norepinephrine kinetics. , 1994, Archives of general psychiatry.

[37]  S. Porges The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system , 2009, Cleveland Clinic Journal of Medicine.

[38]  M. Moeschberger,et al.  Depression as an antecedent to heart disease among women and men in the NHANES I study. National Health and Nutrition Examination Survey. , 2000, Archives of internal medicine.

[39]  K. Felmingham,et al.  Impact of Depression and Antidepressant Treatment on Heart Rate Variability: A Review and Meta-Analysis , 2010, Biological Psychiatry.

[40]  H. Sackeim,et al.  Serotonin, cerebral blood flow, and cerebral metabolic rate in geriatric major depression and normal aging , 1999, Brain Research Reviews.

[41]  Cheryl C. H. Yang,et al.  Effect of aging on gender differences in neural control of heart rate. , 1999, American journal of physiology. Heart and circulatory physiology.

[42]  S. Grundy,et al.  Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International As , 2009, Circulation.

[43]  H G Zapotoczky,et al.  Increased heart rate in depressed subjects in spite of unchanged autonomic balance? , 1998, Journal of affective disorders.