INVESTIGADORES
CASTRO Mariana Nair
artículos
Título:
Acute and Six-Month Depression-Related Abnormalities in the Sleep-Wake Rhythm of Cardiac Autonomic Activity in Survivors of Acute Coronary Syndromes
Autor/es:
MARIANA N. CASTRO; DANIEL E. VIGO; GUSTAFSON D.; VILA-PEREZ I; PILAR MASSARO; CELESTE GARCÍA; CHARLES B. NEMEROFF; SALVADOR M. GUINJOAN; MARÍA SOLEDAD LADRÓN DE GUEVARA
Revista:
PERSONALIZED MEDICINE IN PSYCHIATRY
Editorial:
ELSEVIER SCIENCE BV
Referencias:
Año: 2017
ISSN:
2468-1717
Resumen:
Objectives:To characterize the influence of changes in depression symptoms severity sixmonths after an acute coronary syndrome (ACS) on the circadian pattern ofcardiac autonomic activity, a known independent predictor of adverse outcomes.Methods:One hundred two patients consecutively admitted to the coronary care unit (CCU)with an ACS were evaluated with a clinical interview (including a psychiatricevaluation for depression), the 21-item Hamilton Depression Scale (HAM-D) forsymptom severity and a 24h recording of heart rate variability (HRV) atadmission and six months post-discharge from the CCU. HRV was measured duringwake and sleep (23.00h-07.00h) with a fast Fourier transform algorithm. Weobtained meanRR (mRR), low-frequency HRV (LF) influenced by both sympatheticand parasympathetic activity, high-frequency HRV (HF) determined solely byparasympathetic activity, and LF/HF ratio as a measure of the sympatho-vagalbalance onto the heart (LF/HF). Results:Upon admission to the CCU, major depression was present in 44% of subjects.Depression was associated with shorter mRR (higher heart rate), during sleep(p<0.05). At six months, depression was associated with shorter mRR duringwake (p<0.05) and sleep (p<0.01), decreased mRR sleep-wake difference(p<0.05), and lower LF both during wake (p<0.05) and sleep (p<0.05).LF and HF changes were related to HAM-D changes 6 months after the indexepisode.Conclusions:Depression influenced circadian rhythm of autonomic activity, most notably upon6-month follow up. Changes in depressive symptom severity after a 6-monthobservation period were related to changes in HRV known to adversely affectcoronary prognosis.
