Herhaus Benedict, Siepmann Martin, Kahaly George J, Conrad Rupert, Petrowski Katja
From the Medical Psychology and Medical Sociology (Herhaus, Petrowski), University Medical Center of the Johannes Gutenberg University Mainz, Mainz; Clinic for Psychotherapy and Psychosomatic Medicine (Siepmann), University Hospital Carl Gustav Carus, Technical University Dresden, Dresden; Department of Medicine I (Kahaly), Johannes Gutenberg University Medical Center, Mainz; and Department of Psychosomatic Medicine und Psychotherapy (Conrad), University Hospital Bonn, Bonn, Germany.
Psychosom Med. 2022;84(2):199-209. doi: 10.1097/PSY.0000000000001031.
Some individuals with panic disorder (PD) display reduced heart rate variability (HRV), which may result in an increased risk of cardiovascular mortality. Heart rate variability-biofeedback (HRV-BF) training has been shown to improve the modulation of the autonomic activity. Therefore, this randomized controlled trial was conducted to investigate the effect of a 4-week HRV-BF intervention in individuals with PD. HRV-BF training improved the modulation of the autonomic activity. Therefore, with this randomized controlled trial, we aimed to investigate the effect of a 4-week HRV-BF intervention in people with PD.
Thirty-six women and 16 men with PD (mean age = 35.85 [15.60] years) were randomly allocated either to HRV-BF with 0.1-Hz breathing as intervention group or to HRV-Sham-BF as active control group. HRV-BF was performed for 4 weeks, whereas HRV was measured both during a short-term resting condition and during a paced breathing condition before and after intervention.
HRV-BF with 0.1-Hz breathing increased HRV and reduced panic symptoms in individuals with PD. HRV-BF with 0.1-Hz breathing demonstrated an increase in the time and frequency domain parameters of HRV during the short-term resting condition (ΔPost-Pre root mean square successive differences: 5.87 [14.03] milliseconds; ΔPost-Pre standard deviation of all NN intervals: 11.63 [17.06] milliseconds; ΔPost-Pre total power: 464.88 [1825.47] milliseconds2; ΔPost-Pre power in low-frequency range 0.04-0.15 Hz: 312.73 [592.71] milliseconds2), a decrease in the heart rate during the paced breathing condition (ΔPost-Pre: -5.87 [9.14] beats/min), and a decrease in the Panic and Agoraphobia Scale (ΔPost-Pre: -3.64 [6.30]). There was no intervention effect in the HRV-Sham-BF group.
HRV-BF as a noninvasive and nonpharmacological treatment seems to be an important intervention option to improve reduced HRV and decrease panic symptoms in individuals with PD. Future studies are needed to establish whether these effects translate to reductions in the risk of cardiovascular disease in PD.
一些惊恐障碍（PD）患者表现出心率变异性（HRV）降低，这可能会增加心血管疾病死亡风险。心率变异性生物反馈（HRV-BF）训练已被证明可改善自主神经活动的调节。因此，本随机对照试验旨在研究为期4周的HRV-BF干预对PD患者的影响。HRV-BF训练改善了自主神经活动的调节。因此，通过本随机对照试验，我们旨在研究为期4周的HRV-BF干预对PD患者的影响。
36名患有PD的女性和16名男性（平均年龄=35.85[15.60]岁）被随机分配到以0.1赫兹呼吸进行HRV-BF的干预组或HRV假生物反馈的活性对照组。HRV-BF进行4周，而在干预前后的短期静息状态和定频呼吸状态下均测量HRV。
以0.1赫兹呼吸进行的HRV-BF增加了PD患者的HRV并减轻了惊恐症状。以0.1赫兹呼吸进行的HRV-BF在短期静息状态下显示HRV的时域和频域参数增加（前后差值：均方根连续差值5.87[14.03]毫秒；所有NN间期标准差前后差值：11.63[17.06]毫秒；总功率前后差值：464.88[1825.47]毫秒²；低频范围0.04 - 0.15赫兹功率前后差值：312.73[592.71]毫秒²），在定频呼吸状态下心率降低（前后差值：-5.87[9.14]次/分钟），以及惊恐和场所恐惧症量表得分降低（前后差值：-3.64[6.30]）。HRV假生物反馈组没有干预效果。
HRV-BF作为一种非侵入性和非药物治疗方法，似乎是改善PD患者HRV降低和减轻惊恐症状的重要干预选择。未来需要进行研究以确定这些效果是否能转化为降低PD患者心血管疾病的风险。
