Depression, heart rate variability, and acute myocardial infarction

Circulation. 2001 Oct 23;104(17):2024-8. doi: 10.1161/hc4201.097834.

Abstract

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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Autonomic Nervous System / physiopathology
  • Confounding Factors, Epidemiologic
  • Demography
  • Depression / complications
  • Depression / physiopathology*
  • Depression / therapy*
  • Electrocardiography, Ambulatory
  • Female
  • Heart Conduction System / physiopathology
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / complications
  • Myocardial Infarction / mortality
  • Myocardial Infarction / physiopathology*
  • Neuropsychological Tests
  • Risk Factors
  • Signal Processing, Computer-Assisted
  • Social Isolation