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Increased sympathetic tone is associated with illness burden in bipolar disorder
A. Ortiz, K. Bradler, P. Moorti, S. MacLean, M. Ishrat Husain, M. Sanches, BI. Goldstein, M. Alda, BH. Mulsant
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články, Research Support, N.I.H., Extramural, práce podpořená grantem
Grantová podpora
CIHR - Canada
- MeSH
- bipolární porucha * epidemiologie MeSH
- lidé MeSH
- osobní újma zaviněná nemocí MeSH
- průřezové studie MeSH
- srdeční frekvence MeSH
- úzkostné poruchy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
BACKGROUND: We recently described an association between reduced heart rate variability (HRV) and illness burden in bipolar disorder (BD) using a novel Illness Burden Index (IBI). We aimed to further characterize this association by using spectral analyses to assess whether the IBI is also associated with autonomic imbalance in BD patients. METHODS: In this cross-sectional study, 53 participants with BD wore a device for 24 h to assess association between HRV spectral measures and the IBI or each of its components (age of onset, number and type of previous episode(s), duration of the most severe episode, history of suicide attempts or psychotic symptoms during episodes, co-morbid psychiatric disorders, and family history). We ran both unadjusted models and models controlling for age, sex, years of education, marital status, BMI, pharmacotherapy, and baseline functional cardiovascular capacity. RESULTS: HRV low-frequency (LF) normalized values were almost twice as high as published in healthy controls. Higher IBI was associated with higher LF and lower High Frequency (HF) values, resulting in a higher LF/HF ratio, indicating an increased sympathetic tone. Four individual components of the IBI were similarly associated with measures of increased sympathetic tone: earlier age of onset, number of depressive episodes, co-morbid anxiety disorders, and family history of suicide. Adjusted and unadjusted models had similar results. LIMITATIONS: Our models used mean LF and HF and do not consider their dynamic variations over 24 h or phase of the illness. CONCLUSIONS: Burden of illness is associated with increased sympathetic tone in patients with BD, putting them at risk for arrythmias and sudden death.
Centre for Addiction and Mental Health Toronto ON Canada
Department of Psychiatry Dalhousie University Halifax NS Canada
Department of Psychiatry University of Toronto 100 Stokes St Rm 4229 Toronto ON M6J 1H4 Canada
Institute for Mental Health Research The Royal Ottawa Hospital Ottawa ON Canada
Citace poskytuje Crossref.org
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- $a Ortiz, Abigail $u Department of Psychiatry, University of Toronto, 100 Stokes St., Rm 4229, Toronto, ON M6J 1H4, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada. Electronic address: Abigail.ortiz@utoronto.ca
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- $a BACKGROUND: We recently described an association between reduced heart rate variability (HRV) and illness burden in bipolar disorder (BD) using a novel Illness Burden Index (IBI). We aimed to further characterize this association by using spectral analyses to assess whether the IBI is also associated with autonomic imbalance in BD patients. METHODS: In this cross-sectional study, 53 participants with BD wore a device for 24 h to assess association between HRV spectral measures and the IBI or each of its components (age of onset, number and type of previous episode(s), duration of the most severe episode, history of suicide attempts or psychotic symptoms during episodes, co-morbid psychiatric disorders, and family history). We ran both unadjusted models and models controlling for age, sex, years of education, marital status, BMI, pharmacotherapy, and baseline functional cardiovascular capacity. RESULTS: HRV low-frequency (LF) normalized values were almost twice as high as published in healthy controls. Higher IBI was associated with higher LF and lower High Frequency (HF) values, resulting in a higher LF/HF ratio, indicating an increased sympathetic tone. Four individual components of the IBI were similarly associated with measures of increased sympathetic tone: earlier age of onset, number of depressive episodes, co-morbid anxiety disorders, and family history of suicide. Adjusted and unadjusted models had similar results. LIMITATIONS: Our models used mean LF and HF and do not consider their dynamic variations over 24 h or phase of the illness. CONCLUSIONS: Burden of illness is associated with increased sympathetic tone in patients with BD, putting them at risk for arrythmias and sudden death.
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