Depression, heart rate variability, and acute myocardial infarction

Robert M. Carney, James A. Blumenthal, Phyllis K. Stein, Lana Watkins, Diane Catellier, Lisa F. Berkman, Susan M. Czajkowski, Christopher O'Connor, Peter H. Stone, Kenneth E. Freedland

Research output: Contribution to journalArticlepeer-review

621 Scopus citations

Abstract

Background - Clinical depression is associated with an increased risk for mortality in patients with a recent myocardial infarction (MI). Reduced heart rate variability (HRV) has been suggested as a possible explanation for this association. The purpose of this study was to determine if depression is associated with reduced HRV in patients with a recent MI. Methods and Results - Three hundred eighty acute MI patients with depression and 424 acute MI patients without depression were recruited. All underwent 24-hour ambulatory electrocardiographic monitoring after hospital discharge. In univariate analyses, 4 indices of HRV were significantly lower in patients with depression than in patients without depression. Variables associated with HRV were then compared between patients with and without depression, and potential confounds were identified. These variables (age, sex, diabetes, and present cigarette smoking) were entered into an analysis of covariance model, followed by depression status. In the final model, all but one HRV index (high-frequency power) remained significantly lower in patients with depression than in patients without depression. Conclusions - We conclude that greater autonomic dysfunction, as reflected by decreased HRV, is a plausible mechanism linking depression to increased cardiac mortality in post-MI patients.

Original languageEnglish
Pages (from-to)2024-2028
Number of pages5
JournalCirculation
Volume104
Issue number17
DOIs
StatePublished - Oct 23 2001

Keywords

  • Depression
  • Heart rate variability
  • Myocardial infarction

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