Depression and Heart Rate Variability in Patients With Stable Coronary Heart Disease

Abstract

Major depression is an independent predictor of morbidity and mortality in patients with stable coronary heart disease (CHD) and after myocardial infarction (MI).^1-10 Several factors have been proposed as potential mechanisms by which depression may lead to CHD events, including increased sympathetic tone, elevated catecholamine levels, alterations in cortisol levels, increased platelet aggregation, inflammatory processes, antidepressant cardiotoxicity, and nonadherence to cardiac prevention and treatment regimens.¹¹ Of these, the potential effect of depression on the autonomic nervous system has emerged as one of the most intriguing pathways by which depression may lead to CHD events.