Depression but not anxiety influences the autonomic control of heart rate after myocardial infarction

Maria Vittoria Pitzalis, Massimo Iacoviello, Orlando Todarello, Agnese Fioretti, Pietro Guida, Francesco Massari, Filippo Mastropasqua, Giovanni Dello Russo, Paolo Rizzon

Research output: Contribution to journalArticle

Abstract

Aims: It has been previously hypothesized that the adverse outcome observed in depressed patients after myocardial infarction might be due to an imbalance in autonomic nervous system activity. The aim of this study was to define the role of depressive and anxious symptoms in influencing autonomic control of heart rate after myocardial infarction. Methods and Results: The SD of RR intervals, baroreflex sensitivity, and depression and anxiety (Zung's scales) were assessed before discharge in 103 patients with acute myocardial infarction; 32 were found to be depressed. Among the patients who were not taking β-blockers, those with depression had significantly lower SDs of RR intervals and baroreflex sensitivity than did those without depression (96.3 ± 22.2 ms vs 119.5 ± 37.7 ms, P = .016; 8.6 ± 6.2 ms vs 11.8 ± 6.5 ms/mm Hg, P = .01, respectively). No differences were found when anxiety was considered or when β-blockers were given. Among the patients not taking β-blockers, there was a significant correlation between depression levels and both the SD of RR intervals (r = -0.47) and baroreflex sensitivity (r = -0.40). Conclusions: In patients with myocardial infarction, depression but not anxiety negatively influences autonomic control of heart rate. β-Blockers modify these influences.

Original languageEnglish
Pages (from-to)765-771
Number of pages7
JournalAmerican Heart Journal
Volume141
Issue number5
DOIs
Publication statusPublished - 2001

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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