Autonomic cardiovascular dysregulation as a potential mechanism underlying depression and coronary artery bypass grafting surgery outcomes.
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.
Type
Journal articleSubject
Autonomic Nervous SystemCoronary Artery Bypass
Coronary Disease
Depressive Disorder
Heart Rate
Humans
Length of Stay
Norepinephrine
Treatment Outcome
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https://hdl.handle.net/10161/4384Published Version (Please cite this version)
10.1186/1749-8090-5-36Publication Info
Dao, Tam K; Youssef, Nagy A; Gopaldas, Raja R; Chu, Danny; Bakaeen, Faisal; Wear,
Emily; & Menefee, Deleene (2010). Autonomic cardiovascular dysregulation as a potential mechanism underlying depression
and coronary artery bypass grafting surgery outcomes. J Cardiothorac Surg, 5. pp. 36. 10.1186/1749-8090-5-36. Retrieved from https://hdl.handle.net/10161/4384.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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