Yeragani V K, Rao K A, Pohl R, Jampala V C, Balon R
Department of Psychiatry, Wayne State University School of Medicine, Detroit, Michigan, USA.
Depress Anxiety. 2001;13(2):72-7. doi: 10.1002/da.1019.
This study compared beat-to-beat heart rate and QT variability in children with anxiety disorders (n = 7) and normal controls (n = 15) by using an automated algorithm to compute QT intervals. An increase in QT variability appears to be associated with a higher risk for sudden cardiac death. A decrease in heart rate variability is also linked to significant cardiovascular events. Supine detrended QT variability, QT variability corrected for mean QT interval, and QTvi (a log ratio of QT variance normalized for mean QT over heart rate variability normalized for mean heart rate) were significantly higher in children with anxiety compared to controls (P < 0.05). The largest Lyapunov Exponent (LLE) of heart rate time series was significantly lower (P < 0.05) in children with anxiety compared to controls. These findings suggest a relative increase in sympathetic activity and a relative decrease in cardiac vagal activity in children with anxiety disorders, and are discussed in the context of the effects of tricyclics on cardiac autonomic function in children, and the rare occurrence of sudden death during tricyclic antidepressant treatment.
本研究通过使用一种自动算法来计算QT间期，比较了焦虑症患儿（n = 7）和正常对照组（n = 15）逐搏心率和QT变异性。QT变异性增加似乎与心脏性猝死风险较高有关。心率变异性降低也与重大心血管事件相关。与对照组相比，焦虑症患儿的仰卧位去趋势QT变异性、校正平均QT间期后的QT变异性以及QTvi（QT方差与平均QT的对数比，经平均心率归一化的心率变异性归一化）显著更高（P < 0.05）。与对照组相比，焦虑症患儿心率时间序列的最大Lyapunov指数（LLE）显著更低（P < 0.05）。这些发现提示焦虑症患儿交感神经活动相对增加，心脏迷走神经活动相对减少，并结合三环类药物对儿童心脏自主神经功能的影响以及三环类抗抑郁药治疗期间猝死的罕见情况进行了讨论。
