Circulation. 2001;104:2024-2028
doi: 10.1161/hc4201.097834
doi: 10.1161/hc4201.097834
(Circulation. 2001;104:2024.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Depression, Heart Rate Variability, and Acute Myocardial Infarction
From the Departments of Psychiatry (R.M.C., K.E.F.) and Medicine (P.K.S.), Washington University School of Medicine, St Louis, Mo; Departments of Psychiatry (J.A.B., L.W.) and Medicine (C.O.C.), Duke University, Durham, NC; Department of Biostatistics (D.C.), University of North Carolina, Raleigh, NC; Departments of Epidemiology (L.F.B.) and Medicine (P.H.S.), Harvard University, Boston Mass; and National Heart, Lung, and Blood Institute (S.M.C.), Bethesda, Md.
Correspondence to Robert M. Carney, PhD, Behavioral Medicine Center, 4625 Lindell Blvd, Suite 420, St Louis, MO 63108. E-mail carneyr{at}bmc.wustl.edu
Background— Clinical depression is associated with an increased risk for mortality in patients with a recent myocardial infarction (MI). Reduced heart rate variability (HRV) has been suggested as a possible explanation for this association. The purpose of this study was to determine if depression is associated with reduced HRV in patients with a recent MI.
Methods and Results— Three hundred eighty acute MI patients with depression and 424 acute MI patients without depression were recruited. All underwent 24-hour ambulatory electrocardiographic monitoring after hospital discharge. In univariate analyses, 4 indices of HRV were significantly lower in patients with depression than in patients without depression. Variables associated with HRV were then compared between patients with and without depression, and potential confounds were identified. These variables (age, sex, diabetes, and present cigarette smoking) were entered into an analysis of covariance model, followed by depression status. In the final model, all but one HRV index (high-frequency power) remained significantly lower in patients with depression than in patients without depression.
Conclusions— We conclude that greater autonomic dysfunction, as reflected by decreased HRV, is a plausible mechanism linking depression to increased cardiac mortality in post-MI patients.
Key Words: depression • myocardial infarction • heart rate variability
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 P. Philip-Couderc, F. Smih, M. Pelat, C. Vidal, P. Verwaerde, A. Pathak, S. Buys, M. Galinier, J.-M. Senard, and P. Rouet Cardiac Transcriptome Analysis in Obesity-Related Hypertension Hypertension, March 1, 2003; 41(3): 414 - 421. [Abstract] [Full Text] [PDF]
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S. H. Hohnloser and B. J. Gersh Changing Late Prognosis of Acute Myocardial Infarction: Impact on Management of Ventricular Arrhythmias in the Era of Reperfusion and the Implantable Cardioverter-Defibrillator Circulation, February 25, 2003; 107(7): 941 - 946. [Full Text] [PDF]
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 V. Pignay-Demaria, F. Lesperance, R. G. Demaria, N. Frasure-Smith, and L. P. Perrault Depression and anxiety and outcomes of coronary artery bypass surgery Ann. Thorac. Surg., January 1, 2003; 75(1): 314 - 321. [Abstract] [Full Text] [PDF]
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C. Murr, M. Ledochowski, and D. Fuchs Chronic Immune Stimulation May Link Ischemic Heart Disease With Depression Circulation, April 9, 2002; 105 (14): e83 - e83. [Full Text] [PDF]
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