Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy

Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy

Alexandra Pinter,1,2 Szabolcs Szatmari Jr,1,3–4 Tamas Horvath,5 Ana Isabel Penzlin,6 Kristian Barlinn,7 Martin Siepmann,8 Timo Siepmann1,71Division of Health Care Sciences, Dresden International University, Dresden, Germany; 2Department of Family Medicine, Semmelweis University, Budapest,...

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Autores principales: Pinter A, Szatmari S Jr, Horvath T, Penzlin AI, Barlinn K, Siepmann M, Siepmann T
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2019
Materias:
mood disorder
autonomic dysfunction
cardiovascular disease
brain-heart axis
biofeedback
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Acceso en línea:https://doaj.org/article/68ef66ec3361476183686138a36c2df4
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spelling oai:doaj.org-article:68ef66ec3361476183686138a36c2df42021-12-02T13:18:28ZCardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy1178-2021https://doaj.org/article/68ef66ec3361476183686138a36c2df42019-05-01T00:00:00Zhttps://www.dovepress.com/cardiac-dysautonomia-in-depression-heart-rate-variability-biofeedback--peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Alexandra Pinter,1,2 Szabolcs Szatmari Jr,1,3–4 Tamas Horvath,5 Ana Isabel Penzlin,6 Kristian Barlinn,7 Martin Siepmann,8 Timo Siepmann1,71Division of Health Care Sciences, Dresden International University, Dresden, Germany; 2Department of Family Medicine, Semmelweis University, Budapest, Hungary; 3Department of Neurology, Semmelweis University, Budapest, Hungary; 4Janos Szentagothai Doctoral School of Neurosciences, Semmelweis University, Budapest, Hungary; 5Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary; 6Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 7Department of Neurology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany; 8Department of Psychosomatic Medicine and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, GermanyAbstract: Depressive disorders are among the most important health problems and are predicted to constitute the leading cause of disease burden by the year 2030. Aside significant impact on quality of life, psychosocial well-being and socioeconomic status of affected patients, depression is associated with impaired cardiovascular health and increased mortality. The link between affective and cardiovascular disease has largely been attributed to dysregulation of the autonomic nervous system resulting in a chronic shift toward increased sympathetic and decreased parasympathetic activity and, consecutively, cardiac dysautonomia. Among proposed surrogate parameters to capture and quantitatively analyze this shift, heart rate variability (HRV) and baroreflex sensitivity have emerged as reliable tools. Attenuation of these parameters is frequently seen in patients suffering from depression and is closely linked to cardiovascular morbidity and mortality. Therefore, diagnostic and therapeutic strategies were designed to assess and counteract cardiac dysautonomia. While psychopharmacological treatment can effectively improve affective symptoms of depression, its effect on cardiac dysautonomia is limited. HRV biofeedback is a non-invasive technique which is based on a metronomic breathing technique to increase parasympathetic tone. While some small studies observed beneficial effects of HRV biofeedback on dysautonomia in patients with depressive disorders, larger confirmatory trials are lacking. We reviewed the current literature on cardiac dysautonomia in patients suffering from depression with a focus on the underlying pathophysiology as well as diagnostic workup and treatment.Keywords: mood disorder, autonomic dysfunction, cardiovascular disease, brain-heart axis, biofeedbackPinter ASzatmari S JrHorvath TPenzlin AIBarlinn KSiepmann MSiepmann TDove Medical Pressarticlemood disorderautonomic dysfunctioncardiovascular diseasebrain-heart axisbiofeedbackNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1287-1310 (2019)
institution DOAJ
collection DOAJ
language EN
topic mood disorder
autonomic dysfunction
cardiovascular disease
brain-heart axis
biofeedback
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle mood disorder
autonomic dysfunction
cardiovascular disease
brain-heart axis
biofeedback
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Pinter A
Szatmari S Jr
Horvath T
Penzlin AI
Barlinn K
Siepmann M
Siepmann T
Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy
description Alexandra Pinter,1,2 Szabolcs Szatmari Jr,1,3–4 Tamas Horvath,5 Ana Isabel Penzlin,6 Kristian Barlinn,7 Martin Siepmann,8 Timo Siepmann1,71Division of Health Care Sciences, Dresden International University, Dresden, Germany; 2Department of Family Medicine, Semmelweis University, Budapest, Hungary; 3Department of Neurology, Semmelweis University, Budapest, Hungary; 4Janos Szentagothai Doctoral School of Neurosciences, Semmelweis University, Budapest, Hungary; 5Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary; 6Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 7Department of Neurology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany; 8Department of Psychosomatic Medicine and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, GermanyAbstract: Depressive disorders are among the most important health problems and are predicted to constitute the leading cause of disease burden by the year 2030. Aside significant impact on quality of life, psychosocial well-being and socioeconomic status of affected patients, depression is associated with impaired cardiovascular health and increased mortality. The link between affective and cardiovascular disease has largely been attributed to dysregulation of the autonomic nervous system resulting in a chronic shift toward increased sympathetic and decreased parasympathetic activity and, consecutively, cardiac dysautonomia. Among proposed surrogate parameters to capture and quantitatively analyze this shift, heart rate variability (HRV) and baroreflex sensitivity have emerged as reliable tools. Attenuation of these parameters is frequently seen in patients suffering from depression and is closely linked to cardiovascular morbidity and mortality. Therefore, diagnostic and therapeutic strategies were designed to assess and counteract cardiac dysautonomia. While psychopharmacological treatment can effectively improve affective symptoms of depression, its effect on cardiac dysautonomia is limited. HRV biofeedback is a non-invasive technique which is based on a metronomic breathing technique to increase parasympathetic tone. While some small studies observed beneficial effects of HRV biofeedback on dysautonomia in patients with depressive disorders, larger confirmatory trials are lacking. We reviewed the current literature on cardiac dysautonomia in patients suffering from depression with a focus on the underlying pathophysiology as well as diagnostic workup and treatment.Keywords: mood disorder, autonomic dysfunction, cardiovascular disease, brain-heart axis, biofeedback
format article
author Pinter A
Szatmari S Jr
Horvath T
Penzlin AI
Barlinn K
Siepmann M
Siepmann T
author_facet Pinter A
Szatmari S Jr
Horvath T
Penzlin AI
Barlinn K
Siepmann M
Siepmann T
author_sort Pinter A
title Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy
title_short Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy
title_full Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy
title_fullStr Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy
title_full_unstemmed Cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy
title_sort cardiac dysautonomia in depression – heart rate variability biofeedback as a potential add-on therapy
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/68ef66ec3361476183686138a36c2df4
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