Acute and six-month depression-related abnormalities in the sleep-wake rhythm of cardiac autonomic activity in survivors of acute coronary syndromes

CASTRO, M.N.; VIGO, D.E.; GUSTAFSON, D.R.; VILA-PÉREZ, I.; MASSARO, P.; GARCÍA, C.; NEMEROFF, C.B.; GUINJOAN, S.M.; LADRÓN-DE-GUEVARA, M.S.; CASTRO, M.N.; VIGO, D.E.; GUSTAFSON, D.R.; VILA-PÉREZ, I.; MASSARO, P.; GARCÍA, C.; NEMEROFF, C.B.; GUINJOAN, S.M.; LADRÓN-DE-GUEVARA, M.S.

Personalized Medicine in Psychiatry

Elsevier

Año: 2017

2468-1717

ObjectivesTo characterize the influence of changes in depression symptoms severity six months after an acute coronary syndrome (ACS) on the circadian pattern of cardiac autonomic activity, a known independent predictor of adverse outcomes.MethodsOne hundred two patients consecutively admitted to the coronary care unit (CCU) with an ACS were evaluated with a clinical interview (including a psychiatric evaluation for depression), the 21-item Hamilton Depression Scale (HAM-D) for symptom severity and a 24 h recording of heart rate variability (HRV) at admission and six months post-discharge from the CCU. HRV was measured during wake and sleep (23.00 h?07.00 h) with a fast Fourier transform algorithm. We obtained meanRR (mRR), low-frequency HRV (LF) influenced by both sympathetic and parasympathetic activity, high-frequency HRV (HF) determined solely by parasympathetic activity, and LF/HF ratio as a measure of the sympatho-vagal balance onto the heart (LF/HF).ResultsUpon admission to the CCU, major depression was present in 44% of subjects. Depression was associated with shorter mRR (higher heart rate), during sleep (p