Wang Zuxing, Luo Yuanyuan, Zhang Yuan, Chen Lili, Zou Yazhu, Xiao Jun, Min Wenjiao, Yuan Cui, Ye Yu, Li Mingmei, Tu Mengtian, Hu Jiangli, Zou Zhili
Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China.
Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, PR China.
J Affect Disord. 2023 Jun 1;330:259-266. doi: 10.1016/j.jad.2023.03.018. Epub 2023 Mar 11.
Heart rate variability (HRV) in patients with emotional disorders and healthy controls (HCs) has been investigated in many studies but the difference between these emotional disorders was unclear.
The PubMed, Embase, Medline and Web of Science databases were systematically searched for studies published in English that compared HCs with generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD) patients in HRV. We conducted a network meta-analysis to compare HRV in patients with GAD, MDD, PD and HCs. HRV outcomes, including time domain indices (the standard deviation of NN intervals (SDNN) and the root mean square of the successive differences between normal heartbeats (RMSSD)), and frequency domain indices (High-frequency (HF), Low-frequency (LF) and the ratio of LF to HF (LF/HF)) were obtained. A total of 4008 participants from 42 studies were included.
The results of pairwise meta-analysis showed that compared with controls, GAD, PD and MDD patients exhibited significantly reduced HRV. Similar findings were also confirmed in network meta-analysis. The most important finding from network meta-analysis was that GAD patients had significantly lower SDNN than PD patients (SMD = -0.60, 95 % CI [-1.09, -0.11]).
Our findings provided a potential objective biological marker to distinguish between GAD and PD. In the future, a large sample of research is needed to directly compare HRV of various mental disorders, which is crucial for finding biomarkers to distinguish them.
许多研究对情绪障碍患者和健康对照者的心率变异性（HRV）进行了调查，但这些情绪障碍之间的差异尚不清楚。
系统检索PubMed、Embase、Medline和Web of Science数据库中发表的英文研究，这些研究比较了健康对照者与广泛性焦虑障碍（GAD）、重度抑郁症（MDD）、惊恐障碍（PD）患者的HRV。我们进行了一项网状荟萃分析，以比较GAD、MDD、PD患者和健康对照者的HRV。获取HRV结果，包括时域指标（NN间期标准差（SDNN）和正常心跳间连续差值的均方根（RMSSD））以及频域指标（高频（HF）、低频（LF）和LF与HF之比（LF/HF））。共纳入来自42项研究的4008名参与者。
成对荟萃分析结果显示，与对照组相比，GAD、PD和MDD患者的HRV显著降低。网状荟萃分析也证实了类似的发现。网状荟萃分析最重要的发现是，GAD患者的SDNN显著低于PD患者（标准化均数差= -0.60，95%置信区间[-1.09，-0.11]）。
我们的研究结果提供了一种潜在的客观生物学标志物，用于区分GAD和PD。未来，需要大量样本研究来直接比较各种精神障碍的HRV，这对于寻找区分它们的生物标志物至关重要。
