Research Institute, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.
Biol Psychol. 2012 Jul;90(3):179-85. doi: 10.1016/j.biopsycho.2012.03.016. Epub 2012 Apr 4.
Cardiac autonomic dysfunction has been proposed as an important contributing factor to the increased cardiovascular risk observed in major depression (MDD). However, the evidence regarding alterations in heart rate variability (HRV) in otherwise healthy depressed subjects has been inconclusive.
A case-control study in 50 treatment-naïve young adults with a first MDD episode without comorbid psychiatric disorders and 50 healthy control subjects was conducted. Time- and frequency-domain indexes of HRV were determined at baseline supine and after 5-min of orthostatic stress at 60°.
There were no significant differences in the time- or frequency-domain variables of HRV between depressed patients and controls. However, a random-effect ANOVA model showed that during orthostatic stress depressed men had a reduced HRV and decreased parasympathetic activity compared to control subjects, while no differences were found between depressed women and controls.
These results suggest a sex-dependent relationship between major depression and cardiac autonomic dysfunction and provide one potential explanation for sex differences in the association of depressive symptoms with cardiovascular morbidity.
心脏自主神经功能障碍被认为是导致重度抑郁症（MDD）患者心血管风险增加的一个重要因素。然而，对于无合并精神障碍的首发 MDD 年轻患者的心率变异性（HRV）变化的证据尚无定论。
本研究纳入了 50 例未经治疗的首发 MDD 年轻患者（无合并精神障碍）和 50 例健康对照，采用病例对照研究，在平卧位和 60°直立位 5 分钟后分别记录 HRV 的时域和频域指标。
抑郁患者和对照组在 HRV 的时域和频域变量上无显著差异。然而，随机效应方差分析模型显示，在直立位应激期间，与对照组相比，抑郁男性的 HRV 降低，副交感神经活性降低，而抑郁女性与对照组之间无差异。
这些结果表明，MDD 与心脏自主神经功能障碍之间存在性别依赖性关系，并为抑郁症状与心血管发病率之间的性别差异提供了一种潜在解释。
