Carney Robert M, Freedland Kenneth E
Behavioral Medicine Center, 4320 Forest Park Boulevard, Suite 301, St. Louis, MO 63108, USA.
Cleve Clin J Med. 2009 Apr;76 Suppl 2(Suppl 2):S13-7. doi: 10.3949/ccjm.76.s2.03.
Depression is common in patients with coronary heart disease (CHD) and is a risk factor for cardiac morbidity and mortality in these patients. Depression is associated with autonomic nervous system dysfunction, which may at least partially explain this increased risk. Low heart rate variability (HRV), which reflects excessive sympathetic and/or inadequate parasympathetic modulation of heart rate, is a strong predictor of mortality in patients with CHD. Most studies-both in patients with stable CHD and in patients with a recent acute coronary event-have found HRV to be lower in depressed patients than in their nondepressed counterparts. This manuscript provides an overview of this literature and concludes that HRV may account for a substantial part of the risk associated with depression in CHD.
抑郁症在冠心病（CHD）患者中很常见，并且是这些患者心脏发病和死亡的危险因素。抑郁症与自主神经系统功能障碍有关，这可能至少部分解释了这种风险的增加。心率变异性（HRV）低反映了对心率的过度交感神经调节和/或副交感神经调节不足，是冠心病患者死亡的有力预测指标。大多数研究——无论是在稳定型冠心病患者还是近期发生急性冠脉事件的患者中——都发现，抑郁症患者的HRV低于非抑郁症患者。本文对该文献进行了综述，并得出结论：HRV可能在很大程度上解释了冠心病中与抑郁症相关的风险。
