Heart rate variability increases in elderly depressed patients who respond to electroconvulsive therapy

Aim. To determine heart rate variability (HRV) in depressed patients with chronic coronary artery disease (CAD) and to assess the effects of agomelatine on HRV.Methods. 74 patients with CAD (class 3-4 angina pectoris) were recruited in a study. Patients (n = 45) with CAD and depression were assigned to Group 1, whereas CAD patients (n = 29) without any signs of depression were assigned to Group 2. 17 patients received agomelatine (Subgroup 1) and 28 patients did not take any antidepressants (Subgroup 2). HRV was measured using SCHILLER MT-200 Holter-ECG apparatus at baseline and after 6 months.Results. Patients with depression demonstrated a significant decrease in HRV compared to non-depressed patients (pNN50% (3.9 [2.2; 5.4] vs 5.7 [2.9; 12.6], p = 0.03), SDANN (81 [63; 97] ms vs 91 [79; 102] ms, p = 0.06), SDNNindx (46 [36; 56] ms vs 55 [48; 66] ms, p = 0.002), rMSSD (28 [21; 36] ms vs 33 [ 29; 45] ms, p = 0.02), SDNN (97 [75; 121] ms vs 110 [98; 127] ms, p = 0.02). Subgroups 1 and 2 did not differ in HRV (p>0.05). After 6 months, significant differences in the following parameters were found in those patients who received agomelatine therapy and those who did not: rMSSD (36.5 [28.5; 51] ms vs 26.5 [25; 32] ms, p = 0.02), SDANN (88 [72,5; 114,5] ms vs 67,5 [58; 83] ms, p = 0.03), SDNN strives to a significant difference - 100 [87; 133.5] ms vs 85.5 [75; 103] ms, p = 0.07.Conclusion. HRV significantly decreased in depressed patients with CAD suggesting autonomic dysfunction and worsening their prognosis. Agomelatine therapy in patients with CAD is effective in treating heart rate variability and reducing the risk of developing life-threatening arrhythmias.Key

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Changes in Heart Rate Variability of Depressed Patients after Electroconvulsive Therapy

Cardiovascular Psychiatry and Neurology ◽

10.1155/2012/794043 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Erica B. Royster ◽

Lisa M. Trimble ◽

George Cotsonis ◽

Brian Schmotzer ◽

Amita Manatunga ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Depressive Symptoms ◽

Electroconvulsive Therapy ◽

Low Frequency ◽

Frequency Component ◽

High Frequency Component ◽

Acute Changes ◽

The Impact

Objective. As few, small studies have examined the impact of electroconvulsive therapy (ECT) upon the heart rate variability of patients with major depressive disorder (MDD), we sought to confirm whether ECT-associated improvement in depressive symptoms would be associated with increases in HRV linear and nonlinear parameters. Methods. After providing consent, depressed study participants (n=21) completed the Beck Depression Index (BDI), and 15-minute Holter monitor recordings, prior to their 1st and 6th ECT treatments. Holter recordings were analyzed for certain HRV indices: root mean square of successive differences (RMSSD), low-frequency component (LF)/high-frequency component (HF) and short-(SD1) versus long-term (SD2) HRV ratios. Results. There were no significant differences in the HRV indices of RMSDD, LF/HF, and SD1/SD2 between the patients who responded, and those who did not, to ECT. Conclusion. In the short term, there appear to be no significant improvement in HRV in ECT-treated patients whose depressive symptoms respond versus those who do not. Future studies will reveal whether diminished depressive symptoms with ECT are reliably associated with improved sympathetic/parasympathetic balance over the long-term, and whether acute changes in sympathetic/parasympathetic balance predict improved mental- and cardiac-related outcomes.

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Usefulness of heart rate variability indices in assessing the risk of an unsuccessful return to work after sick leave in depressed patients

Neuropsychopharmacology Reports ◽

10.1002/npr2.12121 ◽

2020 ◽

Vol 40 (3) ◽

pp. 239-245

Author(s):

Toshikazu Shinba ◽

Keizo Murotsu ◽

Yosuke Usui ◽

Yoshinori Andow ◽

Hiroshi Terada ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Sick Leave ◽

Return To Work ◽

Depressed Patients

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Effect of Omega-3 Fatty Acids on Heart Rate Variability in Depressed Patients With Coronary Heart Disease

Psychosomatic Medicine ◽

10.1097/psy.0b013e3181eff148 ◽

2010 ◽

Vol 72 (8) ◽

pp. 748-754 ◽

Cited By ~ 23

Author(s):

Robert M. Carney ◽

Kenneth E. Freedland ◽

Phyllis K. Stein ◽

Brian C. Steinmeyer ◽

William S. Harris ◽

...

Keyword(s):

Fatty Acids ◽

Heart Rate ◽

Coronary Heart Disease ◽

Heart Rate Variability ◽

Heart Disease ◽

Omega 3 Fatty Acids ◽

Omega 3 ◽

Depressed Patients

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Decreased heart rate variability parameters in amitriptyline treated depressed patients: biological and clinical significance

European Psychiatry ◽

10.1016/0767-399x(96)80063-0 ◽

1995 ◽

Vol 10 (4) ◽

pp. 189-194 ◽

Cited By ~ 11

Author(s):

T Rechlin ◽

D Claus ◽

M Weis ◽

WP Kaschka

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Tricyclic Antidepressant ◽

Sinus Arrhythmia ◽

Depressed Patients ◽

Coefficients Of Variation ◽

Reduced Parameters ◽

Unconscious Patients ◽

Age And Sex

SummaryOne hundred-four depressed patients treated with amitriptyline (mean dosage: 163 mg/d; mean plasma level: 239 ng/ml) and 52 normal control subjects matched for age and sex underwent a standardized cardiovascular test battery (various autonomic cardiac parameters, which are largely independent from heart rate, namely the coefficients of variation (CV) while resting and during deep respiration, a spectral analysis of heart rate, the Valsalva ratio, and a posture index were determined). The tests included the determination of time- and frequency-derived measurements of heart rate variability (HRV), which is rather independent from heart rate. As compared to the controls the patients showed a significant plasma concentration-dependent decrease of R-R variation in the electrocardiogram (p < 0.0001), while their heart rate was significantly elevated (p < 0.0001). The markedly reduced parameters of sinus arrhythmia in amitriptyline treated patients are suggested to be mainly due to the anticholinergic effect of this drug, although it can not be excluded that the affective disorder itself might be associated with low heart rate variability. The results indicate that autonomic heart rate parameters are a valuable tool for the detection of tricyclic antidepressant (TCA) intake in unconscious patients, especially in intensive care and emergency wards.

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