Hughes Joel W, Casey Elizabeth, Luyster Faith, Doe Vicki H, Waechter Donna, Rosneck James, Josephson Richard
Kent State University, Kent, OH, USA.
Am Heart J. 2006 May;151(5):1122.e1-6. doi: 10.1016/j.ahj.2006.02.004.
Altered autonomic nervous system (ANS) functioning may help to explain the relationship between depression and cardiac mortality. Heart rate (HR) recovery after the cessation of a treadmill stress test assesses ANS functioning and predicts mortality. This study examined the relationship between depression symptoms and HR recovery among patients entering phase II cardiac rehabilitation.
Two hundred sixty patients were assessed at the time of their enrollment in cardiac rehabilitation. Patients completed a ramped-protocol treadmill stress test, providing an assessment of exercise capacity and HR recovery at 2 minutes post exercise. Depression symptoms were measured using the Beck Depression Inventory. Other medical information was obtained by chart review.
Patients with higher Beck Depression Inventory scores exhibited slower HR recovery after exercise. This remained true after controlling for age, sex, and beta-blocker usage. Controlling for exercise capacity rendered the relationship between depression score and HR recovery non significant, suggesting that exercise capacity may partly account for this relationship.
These findings confirm that depression is characterized by dysregulation of the ANS and implicate impaired exercise capacity as a potential mechanism.
自主神经系统（ANS）功能改变可能有助于解释抑郁症与心脏死亡率之间的关系。跑步机压力测试停止后的心率（HR）恢复情况可评估ANS功能并预测死亡率。本研究调查了进入心脏康复二期的患者中抑郁症状与HR恢复之间的关系。
260名患者在参加心脏康复时接受评估。患者完成了递增式跑步机压力测试，评估了运动能力以及运动后2分钟时的HR恢复情况。使用贝克抑郁量表测量抑郁症状。通过查阅病历获取其他医学信息。
贝克抑郁量表得分较高的患者运动后HR恢复较慢。在控制年龄、性别和β受体阻滞剂使用情况后，这一情况仍然存在。控制运动能力后，抑郁评分与HR恢复之间的关系不再显著，这表明运动能力可能部分解释了这种关系。
这些发现证实抑郁症的特征是ANS调节失调，并表明运动能力受损是一种潜在机制。
