Depression and anxiety as predictors of heart rate variability after myocardial infarction

2007 ◽  
Vol 38 (3) ◽  
pp. 375-383 ◽  
Author(s):  
E. J. Martens ◽  
I. Nyklíček ◽  
B. M. Szabó ◽  
N. Kupper
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Standard Deviation ◽  
Anxiety Disorder ◽  
Depressive Disorder ◽  
Anxiety Symptoms ◽  
Adverse Outcomes ◽  
Depression And Anxiety ◽  
Increased Risk

BackgroundReduced heart rate variability (HRV) is a prognostic factor for cardiac mortality. Both depression and anxiety have been associated with increased risk for mortality in cardiac patients. Low HRV may act as an intermediary in this association. The present study examined to what extent depression and anxiety differently predict 24-h HRV indices recorded post-myocardial infarction (MI).MethodNinety-three patients were recruited during hospitalization for MI and assessed on self-reported symptoms of depression and anxiety. Two months post-MI, patients were assessed on clinical diagnoses of lifetime depressive and anxiety disorder. Adequate 24-h ambulatory electrocardiography data were obtained from 82 patients on average 78 days post-MI.ResultsIn unadjusted analyses, lifetime diagnoses of major depressive disorder was predictive of lower SDNN [standard deviation of all normal-to-normal (NN) intervals; β=−0.26, p=0.022] and SDANN (standard deviation of all 5-min mean NN intervals; β=0.25, p=0.023), and lifetime anxiety disorder of lower RMSSD (root mean square of successive differences; β=−0.23, p=0.039). Depression and anxiety symptoms did not significantly predict HRV. After adjustment for age, sex, cardiac history and multi-vessel disease, lifetime depressive disorder was no longer predictive of HRV. Lifetime anxiety disorder predicted reduced high-frequency spectral power (β=−0.22, p=0.039) and RMSSD (β=−0.25, p=0.019), even after additional adjustment of anxiety symptoms.ConclusionsClinical anxiety, but not depression, negatively influenced parasympathetic modulation of heart rate in post-MI patients. These findings elucidate the physiological mechanisms underlying anxiety as a risk factor for adverse outcomes, but also raise questions about the potential role of HRV as an intermediary between depression and post-MI prognosis.

Resonance breathing is associated with improvements in depression and anxiety symptoms during heart rate variability biofeedback sessions

2021 ◽  
Author(s):  
Adam Khan Pettitt ◽  
Benjamin W Nelson ◽  
Richard Gevirtz ◽  
Paul Lehrer ◽  
Kristian Ranta ◽  
...  
Keyword(s):  
Mental Health ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Resonance Frequency ◽  
Treatment Protocol ◽  
Anxiety Symptoms ◽  
Adjunctive Treatment ◽  
Depression And Anxiety ◽  
Heart Rate Variability Biofeedback ◽  
Item Scale

Heart rate variability (HRV) appears to be a transdiagnostic biomarker for health and disease. Although initial studies using HRV biofeedback (HRVB) to regulate HRV as a potential adjunctive treatment to gold-standard interventions seem promising, more research is needed to determine which aspects of HRVB training provide the most clinical benefits to those suffering from mental health symptoms. In the current study, we sought to investigate whether time spent in resonance, between-person differences in resonance frequency, and/or within-person resonance frequency trajectory across repeated HRVB sessions were related to changes in depression and/or anxiety symptoms during a 12-week digital mental health intervention that contains HRVB as part of the treatment protocol. We used a retrospective cohort study to examine these associations among 387 participants in the Meru Health Program. For depression, we found that average resonance time per HRVB session, but not total time in resonance, was significantly associated with decreased depression as measured by the Patient Health Questionnaire 9-item scale (PHQ-9) across treatment (b=-0.38, 95% CI [-0.76,-0.01], t(377)=-1.99, p=.047). For anxiety symptoms as measured by the Generalized Anxiety Disorder 7-item scale (GAD-7), we found neither association significant. Within-person effects were significant for both depression and anxiety, with steeper slopes of time spent in resonance significantly related to reductions in PHQ-9 and GAD-7 symptoms, respectively. Between-person effects were not significant for either depression or anxiety. Our results demonstrate that improvements in resonance efficiency over time in treatment, independent of how each participant starts, are related to reductions in depression and anxiety symptoms.

Are Trait Emotional Competencies and Heart Rate Variability Linked to Mental Health of Coronary Heart Disease Patients?

2020 ◽  
pp. 003329411989811
Author(s):  
Batselé Elise ◽  
Sophie Vanden Eynde ◽  
Nathalie Egée ◽  
Michel Lamotte ◽  
Philippe Van de Borne ◽  
...  
Keyword(s):  
Heart Rate ◽  
Coronary Heart Disease ◽  
Heart Rate Variability ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Depression Scale ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Emotional Competencies

Purpose Depression and anxiety have been extensively associated with adverse outcomes in coronary heart disease patients. However, psychological and physiological processes underlying the persistence of these troubles in coronary heart disease patients attending cardiac rehabilitation are poorly investigated. Trait emotional competencies and heart rate variability could be some of these processes. Thus, the aim of this study was to assess the predictive value of trait emotional competencies and heart rate variability on depression and anxiety symptoms persistence in coronary heart disease patients. Methods Eighty-four patients who recently presented a myocardial infarction were evaluated at the beginning of cardiac rehabilitation. Forty-two patients continued their rehabilitation program and were then assessed three months later. They completed the Profile of Emotional Competence as well as the Hospital Anxiety and Depression Scale and underwent a 5-minute resting heart rate variability measure. Results Low trait emotional competencies score predicted depression symptoms persistence, but unexpectedly, high trait emotional competencies score was also associated with withdrawal from cardiac rehabilitation. Contrary to our expectations, heart rate variability did not predict depression or anxiety symptoms persistence and was not associated with trait emotional competencies. Conclusions This study is the first to report an association between trait emotional competencies and depression symptoms persistence in coronary heart disease patients. However, heart rate variability was not associated with either depression or anxiety supporting the idea of mixed literature and highlighting the need of future research.

scholarly journals Myocardial infarction and generalised anxiety disorder: 10-year follow-up

2012 ◽  
Vol 200 (4) ◽  
pp. 324-329 ◽  
Author(s):  
Annelieke M. Roest ◽  
Marij Zuidersma ◽  
Peter de Jonge
Keyword(s):  
Myocardial Infarction ◽  
Anxiety Disorder ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Adverse Outcomes ◽  
Generalised Anxiety Disorder ◽  
Cardiovascular Prognosis ◽  
Increased Risk ◽  
And Gender

BackgroundFew studies have addressed the relationship between generalised anxiety disorder and cardiovascular prognosis using a diagnostic interview.AimsTo assess the association between generalised anxiety disorder and adverse outcomes in patients with myocardial infarction.MethodPatients with acute myocardial infarction (n = 438) were recruited between 1997 and 2000 and were followed up until 2007. Current generalised anxiety disorder and post-myocardial infarction depression were assessed with the Composite International Diagnostic Interview. The end-point consisted of all-cause mortality and cardiovascular-related readmissions.ResultsDuring the follow-up period, 198 patients had an adverse event. Generalised anxiety disorder was associated with an increased rate of adverse events after adjustment for age and gender (hazard ratio: 1.94; 95% confidence interval: 1.14–3.30; P = 0.01). Additional adjustment for measures of cardiac disease severity and depression did not change the results.ConclusionsGeneralised anxiety disorder was associated with an almost twofold increased risk of adverse outcomes independent demographic and clinical variables and depression.

scholarly journals Association Between Major Depressive Disorder and Heart Rate Variability in the Netherlands Study of Depression and Anxiety (NESDA)

2008 ◽  
Vol 65 (12) ◽  
pp. 1358 ◽  
Author(s):  
Carmilla M. M. Licht ◽  
Eco J. C. de Geus ◽  
Frans G. Zitman ◽  
Witte J. G. Hoogendijk ◽  
Richard van Dyck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Major Depressive Disorder ◽  
The Netherlands ◽  
Depressive Disorder ◽  
Depression And Anxiety ◽  
Major Depressive

scholarly journals Impedance Cardiography and Heart Rate Variability for Long-Term Cardiovascular Outcome Prediction After Myocardial Infarction

Medicina ◽  
2012 ◽  
Vol 48 (7) ◽  
pp. 52 ◽  
Author(s):  
Rūta Ablonskytė-Dūdonienė ◽  
Giedrė Bakšytė ◽  
Indrė Čeponienė ◽  
Algimantas Kriščiukaitis ◽  
Kęstutis Drėgūnas ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Standard Deviation ◽  
Impedance Cardiography ◽  
Cox Regression ◽  
Secondary Outcome ◽  
Integrated Analysis ◽  
Cardiac Mortality ◽  
Cox Regression Analysis

Background and Objective. The objective of our study was to evaluate the predictive power of a combined assessment of heart rate variability (HRV) and impedance cardiography (ICG) measures in order to better identify the patients at risk of serious adverse events after ST-segment elevation myocardial infarction (STEMI): all-cause or cardiac mortality (primary outcomes) and in-hospital recurrent ischemia, recurrent nonfatal MI, and need for revascularization (secondary outcomes). Material and Methods. A total of 213 study patients underwent 24-hour electrocardiogram (used for HRV analysis) and thoracic bioimpedance monitoring (used for calculation of hemodynamic measures) immediately after admission. The patients were examined on discharge and contacted after 1 and 5 years. Cox regression analysis was used to determine the predictors of selected outcomes. Results. The standard deviation of all normal-to-normal intervals (SDNN) and cardiac power output (CPO) were found to be the significant determinants of 5-year all-cause mortality (SDNN ≤100.42 ms and CPO ≤1.43 W vs. others: hazard ratio [HR], 11.1; 95% CI, 4.48–27.51; P<0.001). The standard deviation of the averages of NN intervals (SDANN) and CPO were the significant predictors of 5-year cardiac mortality (SDANN ≤85.41 ms and CPO ≤1.43 W vs. others: HR, 11.05; 95% CI, 3.75–32.56; P<0.001). None of the ICG measures was significant in predicting any secondary outcome. Conclusions. The patients with both impaired autonomic heart regulation and systolic function demonstrated by decreased heart rate variability and impedance hemodynamic measures were found to be at greater risk of all-cause and cardiac death within a 5-year period after STEMI. An integrated analysis of electrocardiogram and impedance cardiogram helps estimate patient’s risk of adverse outcomes after STEMI.

scholarly journals Measuring Heart Rate Variability in Patients Admitted with ST-Elevation Myocardial Infarction for the Prediction of Subsequent Cardiovascular Events: A Systematic Review

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1021
Author(s):  
Crischentian Brinza ◽  
Mariana Floria ◽  
Adrian Covic ◽  
Alexandru Burlacu
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Events ◽  
St Elevation Myocardial Infarction ◽  
Major Adverse Cardiovascular Events ◽  
Prognostic Information ◽  
Increased Risk ◽  
All Cause Mortality ◽  
St Elevation

Ischemic heart disease represents the leading cause of death, emphasizing risk stratification and early therapeutic intervention. Heart rate variability (HRV), an indirect marker of autonomic nervous system activity, was investigated extensively as a risk factor for adverse cardiovascular events following acute myocardial infarction. Thus, we systematically reviewed the literature to investigate the association of HRV parameters with mortality and adverse cardiovascular events in patients presenting with ST-elevation myocardial infarction (STEMI). Following the search process in the MEDLINE (PubMed), Embase, and Cochrane databases, nine studies were included in the final analysis. Lower time-domain HRV parameters and a higher ratio between power in the low-frequency (LF) band and power in the high-frequency (HF) band (LF/HF) were associated with higher all-cause mortality during follow-up, even in patients treated mainly with percutaneous coronary interventions (PCI). Although most studies measured HRV on 24 h ECG recordings, short- and ultra-short-term measures (1 min and 10 s, respectively) were also associated with an increased risk of all-cause mortality. Although data were discrepant, some studies found an association between HRV and cardiac mortality, reinfarction, and other major adverse cardiovascular events. In conclusion, HRV measurement in patients with STEMI could bring crucial prognostic information, as it was associated with an increased risk of all-cause mortality documented in clinical studies. More and larger clinical trials are required to validate these findings in contemporary patients with STEMI in the context of the new generation of drug-eluting stents and current antithrombotic and risk-modifying therapies.

scholarly journals Determinants of Heart Rate Recovery and Heart Rate Variability in Lung Cancer Survivors Eligible for Long-Term Cure

2018 ◽  
Author(s):  
Duc Ha ◽  
Atul Malhotra ◽  
Andrew L. Ries ◽  
Wesley T. O’Neal ◽  
Mark M. Fuster
Keyword(s):  
Lung Cancer ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Standard Deviation ◽  
Cancer Survivors ◽  
Parasympathetic Nervous System ◽  
Heart Rate Recovery ◽  
Increased Risk ◽  
The Mean

AbstractBackgroundLung cancer survivors are at increased risk for autonomic dysfunction. We aimed to identify determinants of parasympathetic nervous system (PNS) function as reflected by heart rate recovery (HRR) and heart rate variability (HRV) in lung cancer survivors eligible for long-term cure.MethodsWe performed a cross-sectional study of consecutive lung cancer survivors who completed curative-intent therapy for stage I-IIIA ≥1 month previously. We tested a comprehensive list of variables related to baseline demographics, comorbidities, lung cancer characteristics, and physiological/functional measures using univariable and multivariable (MVA) linear regression analyses. We defined HRR as the difference in heart rate (HR) at 1-minute following and the end of the six-minute walk test (6MWT), and HRV the standard deviation of normal-to-normal R-R intervals (SDNN) and root-mean-square-of-successive-differences (rMSSD) from routine single 10-s electrocardiographs (ECGs).ResultsIn 69 participants, the mean (standard deviation, SD) HRR was -10.6 (6.7) beats. In MVAs, significant independent determinants of HRR [β (95% confidence interval)] were: age [0.17 (0.04, 0,30) for each year] and HR change associated with the 6MWT [0.01 (0.007, 0.02) for each beats/min. In 41 participants who had ECGs available for HRV measurements, the mean (SD) SDNN and rMSSD were 19.1 (15.6) and rMSSD 18.2 (14.6) ms, respectively. In MVAs, significant determinants of HRV were: total lung capacity [0.01 (0.00, 0.02), p=0.047 for each % predicted] and HRR [-0.04 (-0.07, -0.003) for each beat] for natural logarithm (Ln-)SDNN; and [0.01 (0.00, 0.02)] and [-0.04 (-0.07, -0.01)] for Ln-rMSSD, respectively.ConclusionsWe measured determinants of HRR and HRV in lung cancer survivors eligible for long-term cure. HRR and/or HRV may be useful as indicators to stratify patients in interventional studies aimed at improving PNS function in lung cancer survivors, including through exercise training.

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