Carney R M, Freedland K E, Rich M W, Smith L J, Jaffe A S
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110.
Am J Med. 1993 Jul;95(1):23-8. doi: 10.1016/0002-9343(93)90228-h.
The purpose of this study was to examine the relationship between psychiatric depression and ventricular arrhythmias in patients with coronary artery disease (CAD). The hypothesis was that depressed patients with CAD would have a higher prevalence of ventricular tachycardia (VT) than nondepressed patients with CAD.
One hundred three patients who were found to have significant CAD by elective diagnostic cardiac catheterization were administered a standardized psychiatric interview and underwent 24-hour Holter monitoring.
Twenty-one patients (20%) met the criteria for either major or minor depression. There were no significant differences between depressed and nondepressed patients with CAD in severity of CAD or in ventricular function. Five (23.8%) of the depressed patients and three (3.7%) of the nondepressed patients exhibited episodes of VT during 24 hours of Holter monitoring (p < 0.008). This difference remained significant even after controlling for relevant covariates.
We conclude that there is a higher prevalence of VT among patients with CAD and depression than among those CAD patients without depression. This may help to explain the increased risk for cardiac mortality in depressed patients with CAD.
本研究旨在探讨冠心病（CAD）患者精神抑郁与室性心律失常之间的关系。研究假设为，患有CAD的抑郁患者室性心动过速（VT）的患病率高于未患抑郁症的CAD患者。
通过选择性诊断性心导管检查发现患有严重CAD的103例患者接受了标准化精神科访谈，并进行了24小时动态心电图监测。
21例患者（20%）符合重度或轻度抑郁症标准。患有CAD的抑郁患者与未患抑郁症的CAD患者在CAD严重程度或心室功能方面无显著差异。在24小时动态心电图监测期间，5例（23.8%）抑郁患者和3例（3.7%）未患抑郁症的患者出现VT发作（p<0.008）。即使在控制了相关协变量后，这种差异仍然显著。
我们得出结论，患有CAD且抑郁的患者中VT的患病率高于未患抑郁症的CAD患者。这可能有助于解释患有CAD的抑郁患者心脏死亡风险增加的原因。
