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年轻人患有重度抑郁症时,其心脏自主功能仍保持正常。

Cardiac autonomic function is preserved in young adults with major depressive disorder.

机构信息

Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States.

Department of Bioengineering, The University of Texas at Arlington, Arlington, Texas, United States.

出版信息

Am J Physiol Heart Circ Physiol. 2024 Mar 1;326(3):H648-H654. doi: 10.1152/ajpheart.00762.2023. Epub 2024 Jan 12.

Abstract

The prevalence of major depressive disorder (MDD) is highest in young adults and contributes to an increased risk of developing future cardiovascular disease (CVD). However, the underlying mechanisms remain unclear. The studies examining cardiac autonomic function that have included young unmedicated adults with MDD report equivocal findings, and few have considered the potential influence of disease severity or duration. We hypothesized that heart rate variability (HRV) and cardiac baroreflex sensitivity (BRS) would be reduced in young unmedicated adults with MDD (18-30 yr old) compared with healthy nondepressed young adults (HA). We further hypothesized that greater symptom severity would be related to poorer cardiac autonomic function in young adults with MDD. Heart rate and beat-to-beat blood pressure were continuously recorded during 10 min of supine rest to assess HRV and cardiac BRS in 28 HA (17 female, 22 ± 3 yr old) and 37 adults with MDD experiencing current symptoms of mild-to-moderate severity (unmedicated; 28 female, 20 ± 3 yr old). Neither HRV [root mean square of successive differences between normal heartbeats (RMSSD): 63 ± 34 HA vs. 79 ± 36 ms MDD; = 0.14] nor cardiac BRS (overall gain, 21 ± 10 HA vs. 23 ± 7 ms/mmHg MDD; = 0.59) were different between groups. In young adults with MDD, there was no association between current depressive symptom severity and either HRV (RMSSD, = 0.004, = 0.73) or cardiac BRS (overall gain, = 0.02, = 0.85). Taken together, these data suggest that cardiac autonomic dysfunction may not contribute to elevated cardiovascular risk factor profiles in young unmedicated adults with MDD of mild-to-moderate severity. This study investigated cardiac autonomic function in young unmedicated adults with major depressive disorder (MDD). The results demonstrated that both heart rate variability and cardiac baroreflex sensitivity were preserved in young unmedicated adults with MDD compared with healthy nondepressed young adults. Furthermore, in young adults with MDD, current depressive symptom severity was not associated with any indices of cardiac autonomic function.

摘要

重度抑郁症(MDD)的患病率在年轻人中最高,并且会增加未来患心血管疾病(CVD)的风险。然而,其潜在的发病机制尚不清楚。已有的研究表明,心脏自主神经功能在未服用药物的年轻 MDD 患者(18-30 岁)中表现出不一致的结果,而且很少有研究考虑到疾病严重程度或持续时间的潜在影响。我们假设与健康未抑郁的年轻成年人(HA)相比,未服用药物的年轻 MDD 患者(18-30 岁)的心率变异性(HRV)和心脏压力反射敏感性(BRS)会降低。我们进一步假设,MDD 患者的症状严重程度与心脏自主神经功能的降低相关。在 28 名 HA(17 名女性,22±3 岁)和 37 名患有 MDD 的成年人(28 名女性,20±3 岁)中,连续记录了 10 分钟仰卧位休息期间的心率和逐拍血压,以评估 HRV 和心脏 BRS。MDD 患者当前处于轻度至中度严重程度的症状期(未服用药物)。两组之间的 HRV[窦性心搏间的正常心跳的均方根差异(RMSSD):63±34 HA 与 79±36 ms MDD; = 0.14]和心脏 BRS(总体增益,21±10 HA 与 23±7 ms/mmHg MDD; = 0.59)均无差异。在患有 MDD 的年轻成年人中,当前抑郁症状的严重程度与 HRV(RMSSD, = 0.004, = 0.73)或心脏 BRS(总体增益, = 0.02, = 0.85)均无相关性。总而言之,这些数据表明,心脏自主神经功能障碍可能不会导致轻度至中度严重程度的未服用药物的年轻 MDD 患者的心血管危险因素水平升高。本研究调查了年轻未服用药物的 MDD 患者的心脏自主神经功能。结果表明,与健康未抑郁的年轻成年人相比,年轻未服用药物的 MDD 患者的心率变异性和心脏压力反射敏感性均正常。此外,在患有 MDD 的年轻成年人中,当前抑郁症状的严重程度与任何心脏自主神经功能指标均无相关性。

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