Cardiac parasympathetic dysfunction related to depression in older adults with acute coronary syndromes.
OBJECTIVE
To determine whether depression is associated with cardiac autonomic alterations in elderly patients with recent acute coronary syndromes (ACSs).


METHODS
Cross-sectional study on the association between a major depressive episode or isolated depressive symptoms (21-item Hamilton depression score) and heart rate variability abnormalities in 56 adults (31 women, 55%) 60 years of age and older with a recent (24-72 h) myocardial infarction (MI) or unstable angina (UA).


RESULTS
Spectral and nonspectral parameters of respiratory sinus arrhythmia, indicative of parasympathetic activity on the heart, were decreased in patients with depression (high-frequency heart rate variability [log ms(2)] 2.12+/-0.4 vs. 2.52+/-0.5, P=.024; pNN50 [%] 1+/-2 vs. 9+/-15, P=.006; and rMSNN [ms] 16+/-6 vs. 28+/-22, P=.009). Also, high-frequency heart rate variability decreased with increasing depressive symptom severity.


CONCLUSIONS
In a sample of older adults suffering from ACSs, depression was associated with impaired parasympathetic control of the heart.
Department of Mental Health and Coronary Care Unit, Hospital de Clínicas "José de San Martín", University of Buenos Aires School of Medicine, Buenos Aires, Argentina. guinjoan@fmed.uba.ar
Salvador M
SM
Guinjoan
M Soledad Ladrón
MS
de Guevara
Carolina
C
Correa
Silvina I
SI
Schauffele
Leonardo
L
Nicola-Siri
Rodolfo D
RD
Fahrer
Enrique
E
Ortiz-Frágola
José A
JA
Martínez-Martínez
Daniel P
DP
Cardinali
D000208:Acute Disease; D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D010275:Parasympathetic Nervous System / Q000503:physiopathology*