Details

Autor(en) / Beteiligte

• de Guevara, M.Soledad Ladrón
• Schauffele, Silvina I.
• Nicola-Siri, Leonardo C.
• Fahrer, Rodolfo D.
• Ortı́z-Frágola, Enrique
• Martı́nez-Martı́nez, José A.
• Cardinali, Daniel P.
• Guinjoan, Salvador M.

Titel

Worsening of depressive symptoms 6 months after an acute coronary event in older adults is associated with impairment of cardiac autonomic function

Ist Teil von

• Journal of affective disorders, 2004-06, Vol.80 (2), p.257-262

Ort / Verlag

Amsterdam: Elsevier B.V

Erscheinungsjahr

2004

Quelle

MEDLINE

Beschreibungen/Notizen

• Background: Depression increases mortality of coronary patients, and autonomic dysfunction has been proposed as an explanation for this association. Methods: In a sample of 38 adults ≥ 60 years with myocardial infarction or unstable angina, we studied depression (presence of a major depressive episode and 21-item Hamilton depression score) and heart rate variability (HRV) of 550 normal beats shortly after admission to the coronary care unit (CCU). Thirty patients were alive at 6 months and were studied at that time as well. Spectral HRV measurements included power in the high-frequency range (HF, 0.15—0.55 Hz, a measure of parasympathetic activity) and low-frequency range (LF, 0.03—0.15 Hz). Nonspectral HRV measurements included standard deviation of normal beats (SDNN) and two measures of vagal activity: percentage of adjacent cycles differing by >50 ms (pNN50) and the root-mean-square of differences in successive beats (rMSNN). Results: Patients who died within 6 months ( n=8) had a higher Hamilton-D score than survivors (13.9±6.5 vs. 18.4±5.6, P=0.039) and were more likely to have an episode of major depression upon admission to the CCU (71 vs. 27%, P=0.027). An increase in Hamilton-D score at 6 months correlated with a decrease in total ( r=–0.48, P=0.014), high-frequency ( r=–0.49, P=0.007), and low-frequency HRV ( r=–0.46, P=0.014). Limitations: Patients belonged to a single institution and there was a small proportion of men. Conclusions: Progression of mood symptoms 6 months after an acute coronary event is associated with an impairment of autonomic control of the heart in elderly individuals.