The moderating role of depressive symptoms in the association between heart rate variability and cognitive performance in cardiac patients

Francesca Mura; Elisabetta Patron; Simone Messerotti Benvenuti; Claudio Gentili; Andrea Ponchia; Franco Del Piccolo; Daniela Palomba

doi:10.1016/j.jad.2023.08.022

The moderating role of depressive symptoms in the association between heart rate variability and cognitive performance in cardiac patients

J Affect Disord. 2023 Nov 1:340:139-148. doi: 10.1016/j.jad.2023.08.022. Epub 2023 Aug 5.

Authors

Francesca Mura¹, Elisabetta Patron², Simone Messerotti Benvenuti³, Claudio Gentili⁴, Andrea Ponchia⁵, Franco Del Piccolo⁶, Daniela Palomba⁴

Affiliations

¹ Department of General Psychology, University of Padua, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Padua, Italy. Electronic address: francesca.mura.1@phd.unipd.it.
² Department of General Psychology, University of Padua, Padua, Italy; SCUP - Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padua, Padua, Italy.
³ Department of General Psychology, University of Padua, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Padua, Italy; SCUP - Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padua, Padua, Italy; Hospital Psychology Unit, Padua University Hospital, Padua, Italy.
⁴ Department of General Psychology, University of Padua, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Padua, Italy; SCUP - Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padua, Padua, Italy.
⁵ Unit of Cardiac Rehabilitation, ULSS 6 Euganea, Padua, Italy.
⁶ Unit of Cardiac Rehabilitation, San Marco Hospital, Venice, Italy.

PMID: 37544481
DOI: 10.1016/j.jad.2023.08.022

Abstract

Introduction: Coronary heart disease (CHD) is strongly associated with cognitive impairment, which is a core feature of depression, highly prevalent in patients with CHD. Interestingly, patients with CHD and individuals with depression display reduced heart rate variability (HRV), which proxies a complex network integrating autonomic and attentional systems. This study investigated the moderating role of depressive symptoms in the relation between reduced HRV and cognitive performance in patients with CHD.

Method: The sample included 274 patients with CHD (mean [standard deviation] age = 62 [9.5] years; 13 % women) admitted to cardiac rehabilitation units. Visual attention and task switching were assessed through the Trail Making Test (TMT). Depressive symptoms were assessed with the Beck Depression Inventory-II (BDI-II). Resting electrocardiographic recordings were collected to compute HRV indices.

Results: Patients with more severe depressive symptoms displayed an inverse association between HRV and cognitive performance (TMT-A: b = -0.08, p = .022; TMTB: b = -0.07, p = .042), whereas patients with milder depressive symptoms showed no significant association (TMT-A: b = -0.00, p = .90; TMTB: b = -0.02, p = .44).

Conclusions: Depressive symptoms may strengthen the relation between reduced HRV and poorer cognitive performance in cardiac patients. The presence of depressive symptoms may signal the dysfunction of a network subserving autonomic and cognitive function.

Keywords: Cardiac vagal tone; Cognitive function; Coronary heart disease; Depression; Heart rate variability.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Arrhythmias, Cardiac / complications
Autonomic Nervous System
Cognition
Coronary Disease* / complications
Coronary Disease* / epidemiology
Depression* / psychology
Female
Heart Rate / physiology
Humans
Male
Middle Aged