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Heart rate variability in patients with coronary artery disease: differences in patients with higher and lower
R Krittayaphong1, W E Cascio, K C Light
1Division of Cardiology, University of North Carolina Schools of Medicine, Chapel Hill, USA.
Insights
Patients with coronary artery disease and higher depression scores exhibit reduced heart rate variability (HRV) during daily life. This finding highlights a potential link between depression and cardiovascular health outcomes.
Area of Science:
- Cardiology
- Psychiatry
- Psychosomatic Medicine
Background:
- Coronary artery disease (CAD) is a significant health concern.
- Depression is frequently observed in CAD patients.
- The impact of depression on cardiac autonomic function in CAD requires further investigation.
Purpose of the Study:
- To test the hypothesis that higher depression scores correlate with lower heart rate variability (HRV) in patients with coronary artery disease.
- To explore the relationship between depression and daily life cardiac autonomic function in a CAD population.
Main Methods:
- Thirty-three men and nine women with diagnosed coronary artery disease and exercise-induced ischemia were enrolled.
- Twenty-four-hour ambulatory electrocardiographic monitoring was used to assess HRV, specifically the standard deviation of normal R-R intervals (SDNN) and average heart rate.
- Patients were categorized into high and low depression groups based on a median split of their Minnesota Multiphasic Personality Inventory Depression (MMPI-D) scores.
Main Results:
- Patients with higher depression scores demonstrated significantly lower SDNN (p = .009), indicating reduced HRV.
- Higher depression scores were associated with a higher average heart rate (p = .003).
- These associations remained robust after adjusting for gender, the only varying demographic/clinical factor.
Conclusions:
- Individuals with coronary artery disease and elevated depression scores exhibit diminished heart rate variability during daily life.
- The observed reduction in HRV in depressed CAD patients may contribute to the known association between depression and increased mortality risk in this population.
- These findings underscore the importance of addressing depression in the management of coronary artery disease.
Objective:
This study tested the hypothesis that coronary artery disease patients with higher depression scores have lower heart rate variability during daily life.
Method:
Thirty-three men and nine women, ranging in age from 46 to 79, with coronary artery disease and exercise-induced ischemia were studied. The standard deviation of normal R-R intervals (SDNN) and average heart rate were obtained from 24-hour ambulatory electrocardiographic monitoring. Patients were grouped by a median split of the Minnesota Multiphasic Personality Inventory (MMPI-D) score.
Results:
SDNN was lower (p = .009) and average heart rate was higher (p = .003) in patients with higher depression scores. These relationships remained substantially unaltered after statistically adjusting for the only demographic/clinical factor that varied between the groups: gender.
Conclusions:
In comparison to the lower depression score group, those with higher depression scores had lower heart rate variability during daily life. These findings may be related to the reported relationship between depression and survival risk in patients with coronary artery disease.