Role of Heart Rate Variability in the Association between Myocardial Infarction Severity and Post-Myocardial Infarction Distress
Objective: Myocardial infarction (MI) results in mental health consequences, including depression and post-traumatic stress disorder (PTSD). The risk and protective factors of such mental consequences are not fully understood. This study examined the relation between MI severity and future mental he...
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MDPI AG
2023-11-01
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| Online Access: | https://www.mdpi.com/2075-1729/13/12/2266 |
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| author | Reham Dyab Claudia Zuccarella-Hackl Mary Princip Sinthujan Sivakumar Rebecca E. Meister-Langraf Hansjörg Znoj Jean-Paul Schmid Jürgen Barth Ulrich Schnyder Roland von Känel Yori Gidron |
| author_facet | Reham Dyab Claudia Zuccarella-Hackl Mary Princip Sinthujan Sivakumar Rebecca E. Meister-Langraf Hansjörg Znoj Jean-Paul Schmid Jürgen Barth Ulrich Schnyder Roland von Känel Yori Gidron |
| author_sort | Reham Dyab |
| collection | DOAJ |
| description | Objective: Myocardial infarction (MI) results in mental health consequences, including depression and post-traumatic stress disorder (PTSD). The risk and protective factors of such mental consequences are not fully understood. This study examined the relation between MI severity and future mental health consequences and the moderating role of vagal nerve activity. Methods: In a reanalysis of data from the Myocardial Infarction-Stress Prevention Intervention (MI-SPRINT) study, 154 post-MI patients participated. MI severity was measured by the Killip Scale and by troponin levels. Depression and PTSD symptoms were assessed with valid questionnaires, both at 3 and 12 months. Vagal nerve activity was indexed by the heart rate variability (HRV) parameter of the root-mean square of successive R-R differences (RMSSD). Following multivariate analyses, the association between MI severity and distress was examined in patients with low and high HRV (RMSSD = 30 ms). Results: In the full sample, the Killip index predicted post-MI distress only at 3 months, while troponin predicted distress at 3- and 12-months post-MI. However, HRV moderated the effects of the Killip classification; Killip significantly predicted symptoms of depression and PTSD at 3- and 12-months post-MI, but only in patients with low HRV. Such moderation was absent for troponin. Conclusion: MI severity (Killip classification) predicted post-MI depression and PTSD symptoms, but only in patients with low HRV, suggesting that the vagal nerve is a partial protective (moderating) factor in the relation between Killip score and post-MI distress. |
| first_indexed | 2024-03-08T20:35:45Z |
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| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-08T20:35:45Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-53ea43ac9db14b1da6b3113abe78101e2023-12-22T14:21:07ZengMDPI AGLife2075-17292023-11-011312226610.3390/life13122266Role of Heart Rate Variability in the Association between Myocardial Infarction Severity and Post-Myocardial Infarction DistressReham Dyab0Claudia Zuccarella-Hackl1Mary Princip2Sinthujan Sivakumar3Rebecca E. Meister-Langraf4Hansjörg Znoj5Jean-Paul Schmid6Jürgen Barth7Ulrich Schnyder8Roland von Känel9Yori Gidron10The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, The University of Haifa, Haifa 3498838, IsraelDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, SwitzerlandDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, SwitzerlandDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, SwitzerlandDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, SwitzerlandDepartment of Clinical Psychology and Psychotherapy, University of Bern, 3012 Bern, SwitzerlandDepartment of Internal Medicine and Cardiology, Clinic Gais AG, 9056 Gais, SwitzerlandInstitute for Complementary and Integrative Medicine, University Hospital Zürich, University of Zürich, 8006 Zurich, SwitzerlandFaculty of Medicine, University of Zürich, 8006 Zurich, SwitzerlandDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, SwitzerlandThe Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, The University of Haifa, Haifa 3498838, IsraelObjective: Myocardial infarction (MI) results in mental health consequences, including depression and post-traumatic stress disorder (PTSD). The risk and protective factors of such mental consequences are not fully understood. This study examined the relation between MI severity and future mental health consequences and the moderating role of vagal nerve activity. Methods: In a reanalysis of data from the Myocardial Infarction-Stress Prevention Intervention (MI-SPRINT) study, 154 post-MI patients participated. MI severity was measured by the Killip Scale and by troponin levels. Depression and PTSD symptoms were assessed with valid questionnaires, both at 3 and 12 months. Vagal nerve activity was indexed by the heart rate variability (HRV) parameter of the root-mean square of successive R-R differences (RMSSD). Following multivariate analyses, the association between MI severity and distress was examined in patients with low and high HRV (RMSSD = 30 ms). Results: In the full sample, the Killip index predicted post-MI distress only at 3 months, while troponin predicted distress at 3- and 12-months post-MI. However, HRV moderated the effects of the Killip classification; Killip significantly predicted symptoms of depression and PTSD at 3- and 12-months post-MI, but only in patients with low HRV. Such moderation was absent for troponin. Conclusion: MI severity (Killip classification) predicted post-MI depression and PTSD symptoms, but only in patients with low HRV, suggesting that the vagal nerve is a partial protective (moderating) factor in the relation between Killip score and post-MI distress.https://www.mdpi.com/2075-1729/13/12/2266myocardial infarctionstress disorderspost-traumatic symptomsdepressive signs and symptomsheart rate determinationmoderation |
| spellingShingle | Reham Dyab Claudia Zuccarella-Hackl Mary Princip Sinthujan Sivakumar Rebecca E. Meister-Langraf Hansjörg Znoj Jean-Paul Schmid Jürgen Barth Ulrich Schnyder Roland von Känel Yori Gidron Role of Heart Rate Variability in the Association between Myocardial Infarction Severity and Post-Myocardial Infarction Distress Life myocardial infarction stress disorders post-traumatic symptoms depressive signs and symptoms heart rate determination moderation |
| title | Role of Heart Rate Variability in the Association between Myocardial Infarction Severity and Post-Myocardial Infarction Distress |
| title_full | Role of Heart Rate Variability in the Association between Myocardial Infarction Severity and Post-Myocardial Infarction Distress |
| title_fullStr | Role of Heart Rate Variability in the Association between Myocardial Infarction Severity and Post-Myocardial Infarction Distress |
| title_full_unstemmed | Role of Heart Rate Variability in the Association between Myocardial Infarction Severity and Post-Myocardial Infarction Distress |
| title_short | Role of Heart Rate Variability in the Association between Myocardial Infarction Severity and Post-Myocardial Infarction Distress |
| title_sort | role of heart rate variability in the association between myocardial infarction severity and post myocardial infarction distress |
| topic | myocardial infarction stress disorders post-traumatic symptoms depressive signs and symptoms heart rate determination moderation |
| url | https://www.mdpi.com/2075-1729/13/12/2266 |
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