Abstract : OBJECTIVES We investigated the relationship between intima-media thickening (IMT) as an expression
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Abstract : OBJECTIVES We investigated the relationship between intima-media thickening (IMT) as an expression of preclinical atherosclerosis and coronary risk factors including the autonomic nervous system and inflammation markers in depressed subjects free from coronary artery disease.|METHODS We studied 391 asymptomatic subjects with a cluster of risk factors and we evaluated depression using the Beck Depression Inventory. IMT of the common carotid artery was determined by B-mode ultrasound imaging. Traditional risk factors for atherosclerosis were recorded. Markers of inflammation (C-reactive protein CRP interleukin 6 IL-6) and heart rate variability (time domain) were determined.|RESULTS A total of 90 (23.0) subjects showed a depressive symptomatology. The average IMT was increased in depressed subjects (0.87+/-0.35 mm) at risk for CHD but free from disease as compared to controls (0.77+/-0.19 mm plt0.001). Heart rate variability was reduced in depressed subjects. Levels of SDNN (103+/-14 ms) and SDANN (93+/-20 ms) were decreased in depressed subjects as compared to non-depressed subjects (SDNN 113+/-22 ms and SDANN 108+/-35 ms plt0.001). Subjects with depression had higher CRP (1.14+/-0.65 mg/dl) and IL-6 (2.00+/-0.40 pg/ml) than subjects without depression (CRP 0.79+/-0.34 mg/dl IL-6 1.6+/-0.6 pg/ml plt0.001 respectively). In multivariate analysis depression was positively correlated with CRP and IL-6 and IMT and inversely associated with levels of SDANN.|CONCLUSIONS: IMT is higher in depressed subjects, indicating that atherosclerosis is accelerated in this sub-group of patients. This is mainly due to patho-physiological mechanisms which connect depression and coronary artery disease, such as inflammation and imbalance of the autonomic nervous system.|
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