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Depression symptoms predict heart rate recovery after treadmill stress testing.

Hughes JW, Casey E, Luyster F, Doe VH, Waechter D, Rosneck J, Josephson R

Kent State University, Kent, OH, USA. jhughes1@kent.edu

BACKGROUND: Altered autonomic nervous system (ANS) functioning may help to explain the relationship between depression and cardiac mortality. Heart rate (HR) recovery after the cessation of a treadmill stress test assesses ANS functioning and predicts mortality. This study examined the relationship between depression symptoms and HR recovery among patients entering phase II cardiac rehabilitation. METHODS: Two hundred sixty patients were assessed at the time of their enrollment in cardiac rehabilitation. Patients completed a ramped-protocol treadmill stress test, providing an assessment of exercise capacity and HR recovery at 2 minutes post exercise. Depression symptoms were measured using the Beck Depression Inventory. Other medical information was obtained by chart review. RESULTS: Patients with higher Beck Depression Inventory scores exhibited slower HR recovery after exercise. This remained true after controlling for age, sex, and beta-blocker usage. Controlling for exercise capacity rendered the relationship between depression score and HR recovery non significant, suggesting that exercise capacity may partly account for this relationship. CONCLUSIONS: These findings confirm that depression is characterized by dysregulation of the ANS and implicate impaired exercise capacity as a potential mechanism.

Published 28 April 2006 in Am Heart J, 151(5): 1122.e1-6.
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