Alteration of cardiac autonomic functions in patients with major depression: A study using heart rate variability measures

• Published in: Journal of affective disorders 2007-06, Vol.100 (1), p.137-141
• Main Authors: Udupa, Kaviraja, Sathyaprabha, T.N, Thirthalli, Jagadisha, Kishore, K.R, Lavekar, G.S, Raju, T.R, Gangadhar, B.N
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Autonomic functions; Autonomic Nervous System Diseases - epidemiology; Autonomic Nervous System Diseases - physiopathology; Biological and medical sciences; Demography; Depression; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Diagnostic and Statistical Manual of Mental Disorders; Electrocardiography; Female; Heart Diseases - epidemiology; Heart Diseases - physiopathology; Heart Rate - physiology; Heart rate variability; Humans; Hypertension - epidemiology; Hypertension - physiopathology; Major depression; Male; Medical sciences; Mood disorders; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Severity of Illness Index; Sympathovagal balance; Vagus Nerve - physiopathology
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2006.10.007

Abstract Background Depression is associated with greater cardiac morbidity and mortality. One of the contributory factors for this may be altered cardiac autonomic activity in depression. However, cardiac autonomic involvement in depression remains controversial because of methodological issues. In this study, alteration of cardiac autonomic functions was studied in drug-naive patients with major depression without co-morbidity. Heart rate variability, a sensitive measure of neurocardiac autonomic regulation was used in addition to conventional methods of measuring cardiac autonomic functions. Methods We recruited 40 patients suffering from major depression, diagnosed based on DSM-IV-TR criteria. Their cardiac autonomic functions were measured using both conventional and heart rate variability measures. These were compared with those of age- and gender-matched healthy controls. Results Patients with major depression showed significantly lesser Valsalva ratio, maximum/minimum ratio and greater sympathovagal balance than healthy controls indicating decreased parasympathetic and increased sympathetic activity. Conclusions Depression is associated with alteration of cardiac autonomic tone towards decreased parasympathetic activity and an increased sympathetic activity. It is possible that a common neurobiological dysfunction contributes to both depression and cardiac autonomic changes in the illness.