Heart rate variability (HRV) is an electrocardiograph-based technique that assesses sympathovagal activity over the heartbeat. Lower HRV (i.e., low power in the low frequency of the power spectral analysis) has been associated with an increased risk for myocardial infarction (
1) and other cardiovascular conditions and thus is a biomarker for cardiac illness. Two articles recently published in Biological Psychiatry showed that lower HRV is observed in major depressive disorder (MDD). However, whereas the meta-analysis of Kemp et al. (
- Buccelletti E.
- Gilardi E.
- Scaini E.
- Galiuto L.
- Persiani R.
- Biondi A.
- et al.
Heart rate variability and myocardial infarction: Systematic literature review and metanalysis.
Eur Rev Med Pharmacol Sci. 2009; 13: 299-307
2) showed that this was associated more robustly with MDD severity, the longitudinal study of Licht et al. (
- Kemp A.H.
- Quintana D.S.
- Gray M.A.
- Felmingham K.L.
- Brown K.
- Gatt J.
Impact of depression and antidepressant treatment on heart rate variability: A review and meta-analysis.
Biol Psychiatry. 2010; 67: 1067-1074
3) observed that antidepressants were associated with lower HRV and their withdrawal with HRV increasing, therefore suggesting that they could play a key role for diminished vagal control over the heart of MDD treated patients. Because such patients present increased cardiovascular burden (
- Licht C.M.
- de Geus E.J.
- van Dyck R.
- Penninx B.W.
Longitudinal evidence for unfavorable effects of antidepressants on heart rate variability.
Biol Psychiatry. 2010; 68: 861-868
4), it is mandatory to investigate whether antidepressants might decrease HRV and whether this contributes to such elevated cardiovascular risk.
- Pizzi C.
- Manzoli L.
- Mancini S.
- Costa G.M.
Analysis of potential predictors of depression among coronary heart disease risk factors including heart rate variability, markers of inflammation, and endothelial function.
Eur Heart J. 2008; 29: 1110-1117
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- Heart rate variability and myocardial infarction: Systematic literature review and metanalysis.Eur Rev Med Pharmacol Sci. 2009; 13: 299-307
- Impact of depression and antidepressant treatment on heart rate variability: A review and meta-analysis.Biol Psychiatry. 2010; 67: 1067-1074
- Longitudinal evidence for unfavorable effects of antidepressants on heart rate variability.Biol Psychiatry. 2010; 68: 861-868
- Analysis of potential predictors of depression among coronary heart disease risk factors including heart rate variability, markers of inflammation, and endothelial function.Eur Heart J. 2008; 29: 1110-1117
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- A study on the effect of the corneal biomechanical properties undergoing overnight orthokeratology.Zhonghua Yan Ke Za Zhi. 2010; 46: 209-213
- Effects of antidepressants on weight and on the plasma levels of leptin, TNF-alpha and soluble TNF receptors: A longitudinal study in patients treated with amitriptyline or paroxetine.Neuropsychopharmacol. 2000; 23: 13-19
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- Effect of tDCS with an extracephalic reference electrode on cardio-respiratory and autonomic functions.BMC Neuroscience. 2010; 11: 38
- Transcranial direct current stimulation influences the cardiac autonomic nervous control.Neuroscience Letters. 2011; 497: 32-36
- Modulation of cardiac autonomic functions in patients with major depression treated with repetitive transcranial magnetic stimulation.J Affect Disord. 2007; 104: 231-236
- Assessing nonlinear properties of heart rate variability from short-term recordings: Are these measurements reliable?.Physiol Meas. 2007; 28: 1067-1077
- Brain and cardiovascular diseases: Common neurogenic background of cardiovascular, metabolic and inflammatory diseases.J Physiol Pharmacol. 2010; 61: 509-521
Published online: December 05, 2011
© 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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- Longitudinal Evidence for Unfavorable Effects of Antidepressants on Heart Rate VariabilityBiological PsychiatryVol. 68Issue 9
- Impact of Depression and Antidepressant Treatment on Heart Rate Variability: A Review and Meta-AnalysisBiological PsychiatryVol. 67Issue 11
- PreviewDepression 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.
- Reply to: Are Antidepressants Good for the Soul but Bad for the Matter? Using Noninvasive Brain Stimulation to Detangle Depression/Antidepressants Effects on Heart Rate Variability and Cardiovascular RiskBiological PsychiatryVol. 71Issue 7
- PreviewWe thank Brunoni et al. (1) for their interesting and thoughtful commentary on our review and meta-analysis on heart rate variability (HRV) (2). Heart rate variability has generated significant interest in the research and clinical communities, because it predicts future mortality (3,4) and might underlie the poor social functioning observed in a variety of psychiatric disorders (5), including major depressive disorder (MDD).