Association between clinical depression and endothelial function measured by forearm hyperemic reactivity.
OBJECTIVE
To assess associations between clinically significant depression (major depressive disorder [MDD] and minor depressive disorder [MiDD]) and endothelial function (EF), via forearm hyperemic reactivity (FHR), in patients referred for myocardial perfusion imaging. Studies have linked MDD to impaired EF, an early marker of coronary heart disease (CHD) and risk factor for cardiac events, in healthy, noncardiac patients, although no studies have assessed the MDD-EF association in patients with or at risk for CHD.


METHODS
Depression was assessed, using the Primary Care Evaluation of Mental Disorders structured interview in 323 patients (n = 242 men; mean age = 59 years) with or at risk for CHD. FHR was assessed, using a dynamic nuclear imaging technique that measures the dilatory capability of the brachial artery during hyperemic challenge. The relative uptake ratio (RUR) of blood flow between hyperemic and nonhyperemic arms was used to measure FHR.


RESULTS
Patients with MDD and MiDD had lower RURs (mean values = 3.31 and 3.34, respectively), indicating poorer EF than patients without depression (mean = 4.27) (F = 5.19, p < .01), irrespective of CHD status. All results were adjusted for covariates including sociodemographic, medical, biochemical, and physiological variables.


CONCLUSIONS
Patients with clinical levels of depression had worse FHR than patients without depression, irrespective of CHD status and after adjusting for covariates. Data extend previous findings, suggesting that the link between clinical depression and worse CHD outcomes may be mediated by EF.
Lavoie
Kim L
KL
Department of Psychology, University of Québec at Montréal, Montréal, Québec, Canada. k-lavoie@crhsc.rtss.qc.ca
Pelletier
Roxanne
R
Arsenault
André
A
Dupuis
Jocelyn
J
Bacon
Simon L
SL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001916:Brachial Artery / Q000503:physiopathology; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology; D003863:Depression / Q000175:diagnosis* / Q000503:physiopathology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide; D009943:Organophosphorus Compounds / Q000008:administration & dosage; D015609:Organotechnetium Compounds / Q000008:administration & dosage; D011569:Psychiatric Status Rating Scales; D012039:Regional Blood Flow; D012307:Risk Factors; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014664:Vasodilation
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D009569:Nitric Oxide; C078700:technetium tc-99m tetrofosmin