In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
Abstract:
Introduction: Depression and cardiovascular disease represent two of the most common causes of disability and mortality. In patients with heart failure (HF), depressive symptoms are related to worse outcomes. Reduced heart rate variability (HRV), as a marker for cardiac autonomic dysfunction, is proposed to mediate the relation between depressive symptoms and cardiovascular health. Hypothesis: This explorative study aims to identify HRV parameters that are related to the somatic-affective and cognitive-affective dimension of depression in subjects with HF, separatly for HF with reduced (HFrEF; EF 〈 50 %) and preserved ejection fraction (HFpEF; EF 〉 50%). Methods: We examined the association between depressiveness as assessed by the Patient-Health-Questionnaire-9 (PHQ-9) and HRV parameters from 24h-Holter ECG recording in the MyoVasc study (NCT04064450; N=3,289), a prospective cohort study on chronic HF. HRV parameters related to PHQ-9 have been selected via elastic net regression. Multivariable linear regression analysis adjusted for age, sex, established cardiovascular risk factors, comorbidities, medication and NTpro-BNP has been performed. Results: In the analysis sample (HRV analysis in N=1,001), 29.8% had mild depressive symptoms (PHQ-9 = 5-9) and 10.2% had major depressive symptoms (PHQ-9 ≥ 10). Elastic net selected 10 HRV parameters. The severity of depression according to PHQ-9 sum scores correlated with triangular index (HRVi) (coefficient estimate (β)) = -0.02, 95% CI: -0.04, -0.006, p = 0.01), acceleration capacity (β = 0.021, 95% CI: 0.004, -0.04, p = 0.02), deceleration capacity (β = -0.02, 95% CI: -0.04, -0.003, p = 0.02), IRRR (β = -0.02, 95% CI: -0.04, -0.003, p = 0.02), SDANN (β = -0.02, 95% CI: -0.04, -0.004, p=0.02) and ULF (β = -0.03, 95% CI: -0.05, -0.01, p = 0.002). Cognitive dimension of depression correlated with HRVi in subjects with HFrEF (β = -0.08, 95% CI: -0.15, -0.008, p = 0.03). Somatic dimension of depression correlated with acceleration capacity in HFpEF (β = 0.06, 95% CI: 0.0025, 0.11, p = 0.04). Conclusions: HRV parameters were consistently more reduced in individuals with more depressive symptoms. Interestingly, HRV parameters differ regarding the cognitive and somatic dimension of depression in individuals with HF.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.144.suppl_1.10922
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
1466401-X
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