抑郁症与心源性猝死及心律失常风险：一项系统评价与荟萃分析
Depression and Risk of Sudden Cardiac Death and Arrhythmias: A Systematic Review and Meta-Analysis.
作者信息
You Yao, Shi Yongmin, Yu Qingwen, Rao Xiyun, Tong Xuhan, Tang Ting, Hu Siqi, Zhang Shenghui, Zhang Xingwei, Wang Hu, Wang Mingwei, Tang Jiake
机构信息
Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Zhejiang Key Laboratory of Medical Epigenetics, School of Basic Medical Sciences, Hangzhou Institute of Cardiovascular Diseases, Engineering Research Center of Mobile Health Management System&Ministry of Education, Hangzhou Normal University, 310015 Hangzhou, Zhejiang, China.
Department of Cardiology, Hangzhou Lin'an Fourth People's Hospital, 311321 Hangzhou, Zhejiang, China.
出版信息
Rev Cardiovasc Med. 2025 Aug 29;26(8):36520. doi: 10.31083/RCM36520. eCollection 2025 Aug.
BACKGROUND
Depression is a highly prevalent mental disorder worldwide and is often accompanied by various somatic symptoms. Clinical studies have suggested a close association between depression and cardiac electrophysiological instability, particularly sudden cardiac death (SCD) and arrhythmias. Therefore, this review systematically evaluated the association between depression and the risks of SCD, atrial fibrillation (AF), and ventricular arrhythmias.
METHODS
This analysis was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The PubMed, Embase, Web of Science, China National Knowledge Infrastructure, VIP, and Wanfang databases were comprehensively searched to identify studies that indicated a correlation between depression and the risk of SCD and arrhythmias from database inception until April 10, 2025. Numerous well-qualified cohort studies were incorporated in this analysis. Correlation coefficients were computed using a random effects model. Statistical analyses were performed using Review Manager 5.4 and STATA 16.0.
RESULTS
A total of 20 studies were included in this meta-analysis. We explored the relationship between depression and SCD as well as arrhythmias. Of these diseases, SCD exhibited a statistically significant association with depression (hazard ratio (HR), 2.52, 95% confidence interval (CI): 1.82-3.49). Ventricular tachycardia (VT)/ventricular fibrillation (VF) was also significantly correlated with depression (HR): 1.38, 95% CI: 1.03-1.86). Depression was also considerably more likely to develop following AF. The results also indicated that AF recurrence (HR: 1.89, 95% CI: 1.54-2.33) was more significant than new-onset AF (HR: 1.10, 95% CI: 0.98-1.25).
CONCLUSIONS
This study highlights a significant association between depression and elevated risks of SCD and arrhythmias, including both AF and VT/VF. These findings underscore the importance of incorporating mental health evaluation into comprehensive cardiovascular risk management strategies.
THE PROSPERO REGISTRATION
CRD42024498196, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024498196.
背景
抑郁症是一种在全球范围内高度流行的精神障碍，常伴有各种躯体症状。临床研究表明，抑郁症与心脏电生理不稳定密切相关，尤其是心源性猝死（SCD）和心律失常。因此，本综述系统评价了抑郁症与SCD、心房颤动（AF）及室性心律失常风险之间的关联。
方法
本分析按照系统评价和Meta分析的首选报告项目指南进行。全面检索了PubMed、Embase、Web of Science、中国知网、维普和万方数据库，以识别从数据库建立至2025年4月10日表明抑郁症与SCD及心律失常风险之间存在相关性的研究。本分析纳入了大量高质量的队列研究。使用随机效应模型计算相关系数。使用Review Manager 5.4和STATA 16.0进行统计分析。
结果
本Meta分析共纳入20项研究。我们探讨了抑郁症与SCD以及心律失常之间的关系。在这些疾病中，SCD与抑郁症表现出统计学上的显著关联（风险比（HR）为2.52，95%置信区间（CI）：1.82 - 3.49）。室性心动过速（VT）/室性颤动（VF）也与抑郁症显著相关（HR：1.38，95% CI：1.03 - 1.86）。抑郁症在AF后发生的可能性也显著更高。结果还表明，AF复发（HR：1.89，95% CI：1.54 - 2.33）比新发AF（HR：1.10，95% CI：0.98 - 1.25）更显著。
结论
本研究突出了抑郁症与SCD及心律失常风险升高之间的显著关联，包括AF和VT/VF。这些发现强调了将心理健康评估纳入全面心血管风险管理策略的重要性。
PROSPERO注册信息：CRD42024498196，https://www.crd.york.ac.uk/PROSPERO/view/CRD42024498196
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