抑郁症,心率变化,以及急性心肌梗塞
R M Carney1, J A Blumenthal, P K Stein
1Departments of Psychiatry, Washington University School of Medicine, St Louis, MO, USA. carneyr@bmc.wustl.edu
Circulation
|October 24, 2001
概括
心脏病发作患者的抑郁症与心率变化 (HRV) 的降低有关,这表明自主功能障碍. 这可能解释了为什么抑郁症在心肌梗塞 (MI) 后增加心脏死亡风险.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 自主神经科学 自主神经科学
背景情况:
- 临床抑郁症是心肌梗塞 (MI) 后患者死亡的已知危险因素.
- 减少心率变化 (HRV) 被假设为调解这种增加的死亡风险.
- 了解后心脏病患者抑郁症和心脏健康之间的联系对于改善结果至关重要.
研究的目的:
- 调查最近发生心肌梗塞 (MI) 的患者中抑郁症和心率变化 (HRV) 之间的联系.
- 为了确定与没有抑郁症的患者相比,患有抑郁症的后心脏病患者的HRV是否显著降低.
主要方法:
- 招募了380名患有抑郁症的急性心脏病发作患者和424名没有抑郁症的患者.
- 在医院出院后进行了24小时的门诊心电图监测.
- 使用单变量分析和协变性分析来评估HRV指数,控制年龄,性别,糖尿病和吸烟等混因素.
主要成果:
- 与非抑郁患者相比,患有抑郁症的患者在四个HRV指数中表现出明显较低的水平.
- 在对共变量进行调整后,三个HRV指数在抑郁组中仍然明显较低.
- 高频功率是唯一的HRV指数,在最终模型中的组之间没有显著差异.
结论:
- 减少HRV,反映自主功能障碍,是一个合理的机制,将抑郁症与心脏病发作后患者心脏病死亡率的增加联系起来.
- 这些发现强调了在心血管保健中解决抑郁症的重要性,以减轻死亡风险.
- 自主功能障碍可能是通过心理困扰影响心脏健康的关键途径.
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