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dc.contributor.author Dao, TK
dc.contributor.author Youssef, NA
dc.contributor.author Gopaldas, RR
dc.contributor.author Chu, D
dc.contributor.author Bakaeen, F
dc.contributor.author Wear, E
dc.contributor.author Menefee, D
dc.coverage.spatial England
dc.date.accessioned 2011-06-21T17:30:25Z
dc.date.issued 2010
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/20465820
dc.identifier 1749-8090-5-36
dc.identifier.citation J Cardiothorac Surg, 2010, 5 pp. 36 - ?
dc.identifier.uri http://hdl.handle.net/10161/4384
dc.description.abstract BACKGROUND: Coronary artery bypass grafting (CABG) is often used to treat patients with significant coronary heart disease (CHD). To date, multiple longitudinal and cross-sectional studies have examined the association between depression and CABG outcomes. Although this relationship is well established, the mechanism underlying this relationship remains unclear. The purpose of this study was twofold. First, we compared three markers of autonomic nervous system (ANS) function in four groups of patients: 1) Patients with coronary heart disease and depression (CHD/Dep), 2) Patients without CHD but with depression (NonCHD/Dep), 3) Patients with CHD but without depression (CHD/NonDep), and 4) Patients without CHD and depression (NonCHD/NonDep). Second, we investigated the impact of depression and autonomic nervous system activity on CABG outcomes. METHODS: Patients were screened to determine whether they met some of the study's inclusion or exclusion criteria. ANS function (i.e., heart rate, heart rate variability, and plasma norepinephrine levels) were measured. Chi-square and one-way analysis of variance were performed to evaluate group differences across demographic, medical variables, and indicators of ANS function. Logistic regression and multiple regression analyses were used to assess impact of depression and autonomic nervous system activity on CABG outcomes. RESULTS: The results of the study provide some support to suggest that depressed patients with CHD have greater ANS dysregulation compared to those with only CHD or depression. Furthermore, independent predictors of in-hospital length of stay and non-routine discharge included having a diagnosis of depression and CHD, elevated heart rate, and low heart rate variability. CONCLUSIONS: The current study presents evidence to support the hypothesis that ANS dysregulation might be one of the underlying mechanisms that links depression to cardiovascular CABG surgery outcomes. Thus, future studies should focus on developing and testing interventions that targets modifying ANS dysregulation, which may lead to improved patient outcomes.
dc.format.extent 36 - ?
dc.language eng
dc.language.iso en_US en_US
dc.relation.ispartof J Cardiothorac Surg
dc.relation.isversionof 10.1186/1749-8090-5-36
dc.subject Autonomic Nervous System
dc.subject Coronary Artery Bypass
dc.subject Coronary Disease
dc.subject Depressive Disorder
dc.subject Heart Rate
dc.subject Humans
dc.subject Length of Stay
dc.subject Norepinephrine
dc.subject Treatment Outcome
dc.title Autonomic cardiovascular dysregulation as a potential mechanism underlying depression and coronary artery bypass grafting surgery outcomes.
dc.title.alternative en_US
dc.type Journal Article
dc.description.version Version of Record en_US
duke.date.pubdate 2010-5-13 en_US
duke.description.endpage 36 en_US
duke.description.issue en_US
duke.description.startpage 36 en_US
duke.description.volume 5 en_US
dc.relation.journal Journal of Cardiothoracic Surgery en_US
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/20465820
pubs.organisational-group /Duke
pubs.organisational-group /Duke/Faculty
pubs.volume 5
dc.identifier.eissn 1749-8090

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