Mura Francesca, Patron Elisabetta, Messerotti Benvenuti Simone, Gentili Claudio, Ponchia Andrea, Del Piccolo Franco, Palomba Daniela
Department of General Psychology, University of Padua, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Padua, Italy.
Department of General Psychology, University of Padua, Padua, Italy; SCUP - Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padua, Padua, Italy.
J Affect Disord. 2023 Nov 1;340:139-148. doi: 10.1016/j.jad.2023.08.022. Epub 2023 Aug 5.
Coronary heart disease (CHD) is strongly associated with cognitive impairment, which is a core feature of depression, highly prevalent in patients with CHD. Interestingly, patients with CHD and individuals with depression display reduced heart rate variability (HRV), which proxies a complex network integrating autonomic and attentional systems. This study investigated the moderating role of depressive symptoms in the relation between reduced HRV and cognitive performance in patients with CHD.
The sample included 274 patients with CHD (mean [standard deviation] age = 62 [9.5] years; 13 % women) admitted to cardiac rehabilitation units. Visual attention and task switching were assessed through the Trail Making Test (TMT). Depressive symptoms were assessed with the Beck Depression Inventory-II (BDI-II). Resting electrocardiographic recordings were collected to compute HRV indices.
Patients with more severe depressive symptoms displayed an inverse association between HRV and cognitive performance (TMT-A: b = -0.08, p = .022; TMTB: b = -0.07, p = .042), whereas patients with milder depressive symptoms showed no significant association (TMT-A: b = -0.00, p = .90; TMTB: b = -0.02, p = .44).
Depressive symptoms may strengthen the relation between reduced HRV and poorer cognitive performance in cardiac patients. The presence of depressive symptoms may signal the dysfunction of a network subserving autonomic and cognitive function.
冠心病（CHD）与认知障碍密切相关，认知障碍是抑郁症的核心特征，在冠心病患者中极为普遍。有趣的是，冠心病患者和抑郁症患者的心率变异性（HRV）均降低，心率变异性代表了一个整合自主神经系统和注意力系统的复杂网络。本研究调查了抑郁症状在冠心病患者HRV降低与认知表现之间关系中的调节作用。
样本包括274名入住心脏康复病房的冠心病患者（平均[标准差]年龄 = 62[9.5]岁；13%为女性）。通过连线测验（TMT）评估视觉注意力和任务转换能力。用贝克抑郁量表第二版（BDI-II）评估抑郁症状。收集静息心电图记录以计算HRV指标。
抑郁症状较严重的患者，HRV与认知表现呈负相关（TMT-A：b = -0.08，p = .022；TMT-B：b = -0.07，p = .042），而抑郁症状较轻的患者则无显著相关性（TMT-A：b = -0.00，p = .90；TMT-B：b = -0.02，p = .44）。
抑郁症状可能会加强冠心病患者HRV降低与较差认知表现之间的关系。抑郁症状的存在可能预示着一个维持自主神经和认知功能的网络功能失调。
