Korea University, Institute of Human Genomic Study, Republic of Korea.
J Psychosom Res. 2013 May;74(5):407-13. doi: 10.1016/j.jpsychores.2013.02.007. Epub 2013 Mar 19.
The current study investigates heart rate variability (HRV) responses to a psychosocial stressor in chronic obstructive pulmonary disease (COPD) patients, and the potential role of anxiety as a confounding factor in this relationship. Additionally, this study also investigates the influence of anxiety on sleep and depressive symptoms among COPD patients.
The study utilized a 2 (disease status)×2 (anxiety group) factorial design examining HRV associated with anxiety symptoms and COPD during a standardized acute social stress task. Participants (mean age 59.1±11.2 years; 50% female) completed pulmonary function testing, HRV monitoring, and self-report questionnaires assessing psychological factors. 30 COPD patients were age- and gender-matched with 30 healthy controls.
HRV response to a psychosocial stressor among participants with higher anxiety (both COPD and healthy) reflected autonomic dysregulation in both time and frequency domains that was not evident among non-anxious participants. COPD participants with higher anxiety reported greater symptoms of depression and poorer sleep quality than did COPD participants with low anxiety.
Anxiety is associated with dysregulated HRV response to a psychosocial stressor, but the negative influence of anxiety and COPD on autonomic function did not appear to be additive. Comorbid anxiety in patients with COPD is associated with increased behavioral and psychological symptoms of distress.
本研究旨在探讨慢性阻塞性肺疾病（COPD）患者在心理社会应激下的心率变异性（HRV）反应，以及焦虑作为这一关系中混杂因素的潜在作用。此外，本研究还探讨了焦虑对 COPD 患者睡眠和抑郁症状的影响。
本研究采用 2（疾病状态）×2（焦虑组）析因设计，在标准化急性社会应激任务中检查与焦虑症状和 COPD 相关的 HRV。参与者（平均年龄 59.1±11.2 岁；50%为女性）完成了肺功能测试、HRV 监测和自我报告问卷，评估心理因素。30 名 COPD 患者与 30 名健康对照者按年龄和性别匹配。
在焦虑程度较高的参与者（COPD 和健康）中，HRV 对心理社会应激的反应反映了自主神经功能在时间和频率两个方面的失调，而在不焦虑的参与者中则没有明显表现。焦虑程度较高的 COPD 参与者报告的抑郁症状和睡眠质量较差，高于焦虑程度较低的 COPD 参与者。
焦虑与心理社会应激下 HRV 反应的失调有关，但焦虑和 COPD 对自主功能的负面影响似乎没有累加作用。COPD 患者合并焦虑与行为和心理困扰症状增加有关。
