Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis.

By Andrew H. Kemp, D. Quintana, Marcus A. Gray, K. Felmingham, K. Brown, J. Gatt. Biological Psychiatry, 2010

1,221 citations recorded by the source corpus.

BACKGROUND Depression is associated with an increase in the likelihood of cardiac events; however, studies investigating the relationship between depression and heart rate variability (HRV) have generally focused on patients with cardiovascular disease (CVD). The objective of the current report is to examine with meta-analysis the impact of depression and antidepressant treatment on HRV in depressed patients without CVD. METHODS Studies comparing 1) HRV in patients with major depressive disorder and healthy control subjects and 2) the HRV of patients with major depressive disorder before and after treatment were considered for meta-analysis. RESULTS Meta-analyses were based on 18 articles that met inclusion criteria, comprising a total of 673 depressed participants and 407 healthy comparison participants. Participants with depression had lower HRV (time frequency: Hedges' g = -.301, p < .001; high frequency: Hedges' g = -.293, p < .001; nonlinear: Hedges' g = -1.955, p = .05; Valsalva ratio: Hedges' g = -.712, p < .001) than healthy control subjects, and depression severity was negatively correlated with HRV (r = -.354, p < .001). Tricyclic medication decreased HRV, although serotonin reuptake inhibitors, mirtazapine, and nefazodone had no significant impact on HRV despite patient response to treatment. CONCLUSIONS Depression without CVD is associated with reduced HRV, which decreases with increasing depression severity, most apparent with nonlinear measures of HRV. Critically, a variety of antidepressant treatments do not resolve these decreases despite resolution of symptoms, highlighting that antidepressant medications might not have HRV-mediated cardioprotective effects and the need to identify individuals at risk among patients in remission.

Subfields: Cardiology and Cardiovascular Medicine

View Paper: https://www.semanticscholar.org/paper/6a9bd721093b7cb26811090aedbb6bf0b9a02ba3

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In Cardiology and Cardiovascular Medicine

Citations in the corpus

Association between heart rate variability and fluctuations in resting-state functional connectivity (2012, background): “HRV is an important predictor of mortality (Huikuri et al., 2009), and decreased HRV is also one welldescribed symptom of ANS dysregulation in depression (Kemp et al., 2010; Licht et al., 2008).”
Heart Rate Variability in Psychology: A Review of HRV Indices and an Analysis Tutorial (2021, background): “Short-term HRV indices such has RMSSD, SDANN, HF and non-linear measures such as MSE were found to be significantly reduced in patients with depression [14,137,138] and negatively correlated with symptom severity [139].”
Methods for cleaning the BOLD fMRI signal (2016, neutral): “In that respect, it is relevant to consider that some neuropsychiatric diseases, e.g. depression, are associated with low heart rate variability (Kemp et al., 2010).”
Understanding the somatic consequences of depression: biological mechanisms and the role of depression symptom profile (2013, background): “The TCA effect on HRV, likely through direct anticholinergic effects, was recently confirmed in a metaanalysis [62].”
A meta-analysis of cognitive deficits in first-episode Major Depressive Disorder. (2012, methodology): “The start date of 1990 was chosen as this was the first time the current construct of “major depression” was in wide-use in the scientific literature (Kemp et al., 2010).”
Depression and Anxiety (2008, neutral): “In 2010, these authors conducted a meta‐analysis concluding that HRV was reduced in patients with depression (Kemp et al., 2010), and in 2012 they conducted a case‐control study showing that the greatest reduction in HRV was displayed in depressed participants with comorbid generalized anxiety…”