The Effect of Autonomic Neural Control on the Cardiovascular System in Patients with Depression

Öz

Purpose: In this study, we aimed to examine hearth rate recovery, systolic blood pressure response to exercise and heart rate variability to reveal the effect of autonomic autonomic neural control on the cardiovascular system in depressed individuals. Methods: A total of 151 patients; (49 out of 75 healthy controls and 54 out of 76 patients with depression were females) were associated to age, sex and physical activity. We examined the difference between heart rate at peak exercise and heart rate recovery at related minute. Systolic blood pressure at 2^nd and 3^rd min of recovery was divided into the systolic blood pressure at peak exercise in order to determine blood pressure recovery indices. Results: Heart rate recovery at first minute was significantly lower in the depression group compared to the control group (p <0.0001). The resting systolic blood pressure was similar in both groups (p = 0.762). Systolic blood pressure during peak exercise was significantly higher in the depression group compared to the control group (p <0.0001). In the depressive patient group, the systolic blood pressure recovery index was significantly higher at 2^nd and 3^rd minutes than the control group (p <0.0001, p = 0.015). Time domain and frequency domain parameters significantly decreased compared to the controls. Conclusion: This study demonstrates that depression is characterized with decreased heart rate recovery, exaggerated systolic blood pressure response to exercise and attenuated heart rate variability. These results may also propose alterations in autonomic neuronal control of the cardiovascular system in depression.

Amaç: Bu çalışmada, depresyonlu bireylerde otonomik nöral kontrolün kardiyovasküler sistem üzerindeki etkisini ortaya çıkarmak için, kalp atım hızı düzelmesini, egzersize verilen sistolik kan basıncı cevabını ve kalp hızı değişkenliğini incelemeyi amaçladık. Yöntem: Toplam 151 hasta (75 sağlıklı kontrolün 49'u ve depresyonlu 76 hastanın 54'ü kadın) yaş, cinsiyet ve fiziksel aktivite ile ilişkilendirildi. Pik egzersizde kalp atış hızı ile ilgili dakikada gerçekleşen  kalp hızı toparlanması arasındaki farkı inceledik. Toparlanmanın 2. ve 3. dakikasındaki sistolik kan basıncı, pik egzersizdeki sistolik kan basıncına bölünerek kan basıncı toparlanma endeksleri belirlendi. Bulgular: Depresyon grubunda birinci dakikadaki kalp hızı toparlanması kontrol grubuna göre anlamlı derecede düşük bulundu (p <0.0001). İstirahat sistolik kan basıncı her iki grupta da benzerdi (p = 0.762). Pik egzersiz sırasında sistolik kan basıncı depresyon grubunda kontrol grubuna göre anlamlı derecede yüksekti (p <0.0001). Depresif hasta grubunda sistolik kan basıncının toparlanma indeksi kontrol grubuna göre 2. ve 3. dakikalarda daha yüksekti (p <0.0001, p = 0.015). Zaman etki alanı ve frekans alanı parametreleri, kontrollere kıyasla önemli ölçüde azaldı. Sonuç: Bu çalışma, depresyonun azalmış kalp hızı toparlanması, egzersize abartılı sistolik kan basıncı cevabı ve azalmış kalp hızı değişkenliği ile karakterize olduğunu göstermektedir. Bu sonuçlar depresyonda kardiyovasküler sistemin otonomik nöral kontrolünde değişiklikler olabileceğini ön görmektedir.

Anahtar Kelimeler

• Depression,hearth rate recovery

Kaynakça

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