Heart rate variability and markers of inflammation and coagulation in depressed patients with coronary heart disease.
BACKGROUND
Depression is associated with an increased risk for cardiac morbidity and mortality in patients with coronary heart disease (CHD). Cardiac autonomic nervous system (ANS) dysregulation, proinflammatory processes, and procoagulant processes have been suggested as possible explanations.


METHODS
Heart rate variability (HRV), an indicator of cardiac autonomic regulation, and markers of inflammation [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha)] and coagulation (fibrinogen) were assessed in 44 depressed patients with CHD.


RESULTS
Moderate, negative correlations were found between fibrinogen and four measures of HRV. IL-6 also negatively correlated with one measure of HRV (total power) and was marginally related to two others (very low frequency and low frequency power). Neither CRP nor TNF-alpha was significantly related to any measure of HRV.


CONCLUSIONS
The finding that fibrinogen and IL-6 are moderately related to HRV suggests a link between these factors in depressed CHD patients. The relationship between ANS function and inflammatory and coagulant processes should be investigated in larger mechanistic studies of depression and cardiac morbidity and mortality.
Carney
Robert M
RM
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA. carneyr@bmc.wustl.edu
Freedland
Kenneth E
KE
Stein
Phyllis K
PK
Miller
Gregory E
GE
Steinmeyer
Brian
B
Rich
Michael W
MW
Duntley
Stephen P
SP
D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D002097:C-Reactive Protein / Q000378:metabolism; D003327:Coronary Disease / Q000097:blood* / Q000523:psychology*; D003863:Depression / Q000097:blood* / Q000523:psychology*; D004562:Electrocardiography; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D018836:Inflammation Mediators; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D005340:Fibrinogen; D002097:C-Reactive Protein