Discipline of Psychiatry, Department of Neuroscience, University of Medicine and Pharmacy "Victor Babes" Timisoara, Eftimie Murgu Place Nr. 2, 300041 Timis, Romania.
Discipline of Cardiology, Department VII, Internal Medicine II, University of Medicine and Pharmacy "Victor Babes" Timisoara, Eftimie Murgu Place Nr. 2, 300041 Timis, Romania.
Medicina (Kaunas). 2020 Nov 5;56(11):590. doi: 10.3390/medicina56110590.
: Major depressive disorder (MDD) and cardiovascular diseases (CVDs) represent serious and prevalent medical conditions. Autonomic nervous system (ANS) dysfunctions, expressed by parameters of heart rate variability (HRV) and heart rate turbulence (HRT), have been repeatedly associated with depression. The aim of our study was to identify potential HRV and HRT alterations in patients with MDD, before and after selective serotonin reuptake inhibitor (SSRI) therapy, and to observe any correlations between these parameters and the severity of depressive symptoms. Another aim was to evidence if there was a normalization or improvement of HRV and HRT parameters that paralleled the reduction of the intensity of depressive symptoms. : We studied heart rate variability (HRV) and heart rate turbulence (HRT) in a sample of 78 patients, aged under 51 years, who were referred to our outpatient clinic between June 2017 and December 2019, for complaints in the context of a new onset major depressive disorder (MDD), before and after therapy with SSRIs. : By using 24 h Holter ECG monitoring, we evidenced alterations of HRV and HRT parameters, significantly correlated with the severity of depressive symptoms ( < 0.001), as assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS). Our results indicated that these parameters improved following one and six months of SSRI therapy, when a partial or total remission of depressive symptoms was achieved ( < 0.001). Changes in HRV parameters were correlated with the reduction of the severity of depression. : In our study group, we highlighted, through 24 h ECG Holter monitoring, frequent and clear HRV and HRT abnormalities that were statistically correlated with the severity of depressive symptoms. Furthermore, we were able to document a progressive improvement of these parameters, which corresponded with the improvement of depressive symptoms under SSRI therapy, when compared to the values measured before the commencement of antidepressant pharmacotherapy.
：重度抑郁症（MDD）和心血管疾病（CVDs）是严重且普遍存在的医学病症。自主神经系统（ANS）功能障碍，通过心率变异性（HRV）和心率震荡（HRT）的参数表现出来，与抑郁反复相关。我们的研究目的是在选择性 5-羟色胺再摄取抑制剂（SSRI）治疗之前和之后，识别 MDD 患者潜在的 HRV 和 HRT 改变，并观察这些参数与抑郁症状严重程度之间的任何相关性。另一个目的是证明 HRV 和 HRT 参数是否存在正常化或改善，这与抑郁症状强度的降低平行。
我们研究了 2017 年 6 月至 2019 年 12 月期间因新发重度抑郁症（MDD）而在我们的门诊就诊的 78 名年龄在 51 岁以下的患者的心率变异性（HRV）和心率震荡（HRT），并在接受 SSRIs 治疗前后进行了监测。
通过使用 24 小时 Holter ECG 监测，我们发现 HRV 和 HRT 参数发生改变，这些参数与抑郁症状的严重程度显著相关（<0.001），评估工具是蒙哥马利-阿斯伯格抑郁评定量表（MADRS）。我们的结果表明，在接受 SSRI 治疗一个月和六个月后，当达到抑郁症状部分或完全缓解时，这些参数得到了改善（<0.001）。HRV 参数的变化与抑郁严重程度的降低相关。
在我们的研究组中，我们通过 24 小时心电图 Holter 监测强调了经常且明显的 HRV 和 HRT 异常，这些异常与抑郁症状的严重程度具有统计学相关性。此外，我们能够记录到这些参数的逐渐改善，这与 SSRI 治疗下抑郁症状的改善相对应，与抗抑郁药物治疗前的测量值相比。
