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青少年时期的重度抑郁症与心血管自主调节和血管功能受损有关。

Major depressive disorder at adolescent age is associated with impaired cardiovascular autonomic regulation and vasculature functioning.

机构信息

Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.

Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic.

出版信息

Int J Psychophysiol. 2022 Nov;181:14-22. doi: 10.1016/j.ijpsycho.2022.08.004. Epub 2022 Aug 25.

DOI:10.1016/j.ijpsycho.2022.08.004
PMID:36029918
Abstract

Cardiovascular adverse complications represent a risk factor for increased cardiovascular morbidity and mortality in patients with major depressive disorder (MDD). However, there is little knowledge of adolescent MDD. We aimed to study complex cardiovascular autonomic regulation and early atherosclerotic damage with a focus on an analysis of heart rate variability (HRV), blood pressure variability (BPV), systolic time intervals, and measures of early atherosclerotic changes in adolescent MDD. Ninety depressive adolescents (34 boys, age 15.8 ± 1.3 yrs.) and 90 age-/gender-matched controls were examined. Evaluated parameters: HRV - time and spectral parameters, BPV - mean, systolic, and diastolic blood pressure, spectral systolic parameters; haemodynamic indices - stroke volume, cardiac output, total peripheral resistance, systolic time intervals - left ventricular ejection time, pre-ejection period; atherosclerotic indices - ankle-brachial index (ABI), pulse wave velocity, brachial-ankle pulse wave velocity, cardio-ankle vascular index; growth factors - epidermal growth factor (EGF), vascular endothelial growth factor associated with monocyte chemoattractant protein-1. Our results showed that the MDD group had significantly reduced HRV and higher BPV measures, shortened systolic time intervals, lower ABI, and higher EGF compared to controls. Concluding, our study revealed that adolescent MDD is associated with cardiovascular dysregulation and early vasculature dysfunction as preclinical markers of higher risk for cardiovascular morbidity, thus adolescence seems to represent an important age period for early diagnosis and prevention of later MDD-linked cardiovascular diseases manifesting in adulthood.

摘要

心血管不良并发症是导致伴有重度抑郁症(MDD)患者心血管发病率和死亡率增加的一个危险因素。然而,对于青少年 MDD 知之甚少。我们旨在研究复杂的心血管自主调节以及早期动脉粥样硬化损伤,重点分析心率变异性(HRV)、血压变异性(BPV)、收缩时间间隔以及青少年 MDD 中的早期动脉粥样硬化变化的测量值。共检查了 90 名抑郁青少年(34 名男性,年龄 15.8 ± 1.3 岁)和 90 名年龄/性别匹配的对照组。评估参数包括:HRV - 时间和频谱参数、BPV - 平均血压、收缩压和舒张压、频谱收缩参数;血流动力学指数 - 每搏输出量、心输出量、总外周阻力、收缩时间间隔 - 左心室射血时间、射血前期;动脉粥样硬化指数 - 踝臂指数(ABI)、脉搏波速度、肱踝脉搏波速度、心踝血管指数;生长因子 - 表皮生长因子(EGF)、与单核细胞趋化蛋白-1 相关的血管内皮生长因子。我们的结果表明,与对照组相比,MDD 组的 HRV 明显降低,BPV 测量值更高,收缩时间间隔缩短,ABI 较低,EGF 较高。总之,我们的研究表明,青少年 MDD 与心血管调节异常和早期血管功能障碍有关,这些都是心血管发病率增加的临床前标志物,因此青少年时期似乎是早期诊断和预防成年后与 MDD 相关的心血管疾病的重要时期。

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