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Heart Rate Variability and Omega-3 Index in Euthymic Patients with Bipolar Disorders

Published online by Cambridge University Press:  15 April 2020

A. Voggt ,
M. Berger ,
M. Obermeier ,
A. Löw ,
F. Seemueller ,
M. Riedel ,
H.J. Moeller ,
R. Zimmermann ,
F. Kirchberg  and
C. Von Schacky
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A. Voggt
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
M. Berger
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany Klinik für Psychiatrie und Psychotherapie, Clienia Schlössli, Oetwil am See, Switzerland
M. Obermeier
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany GKM Gesellschaft für Therapieforschung mbH, Munich, Germany
A. Löw
Affiliation:
Department of Internal Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
F. Seemueller
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany Klinik für Psychiatrie, Psychotherapie und Psychosomatik, kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
M. Riedel
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany Vinzenz-von-Paul-Hospital, Rottweil, Germany
H.J. Moeller
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
R. Zimmermann
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany Klinik für Psychiatrie, Psychotherapie und Psychosomatik, kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
F. Kirchberg
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany
C. Von Schacky
Affiliation:
Department of Preventive Cardiology, Ludwig-Maximilians-Universität München, Munich, Germany
E. Severus*
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, TU Dresden, Germany
*
*Corresponding author. Fetscherstraޥ 74, 01307 Dresden, Germany. Tel.: +49 351 4583780. E-mail address:emanuel.severus@uniklinikum-dresden.de (E. Severus).
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Abstract

Background:

Affective disorders are associated with an increased risk of cardiovascular disease, which, at least partly, appears to be independent of psychopharmacological treatments used to manage these disorders. Reduced heart rate variability (SDNN) and a low Omega-3 Index have been shown to be associated with increased risk for death after myocardial infarction. Therefore, we set out to investigate heart rate variability and the Omega-3 Index in euthymic patients with bipolar disorders.

Methods:

We assessed heart rate variability (SDNN) and the Omega-3 Index in 90 euthymic, mostly medicated patients with bipolar disorders (Bipolar-I, Bipolar-II) on stable psychotropic medication, free of significant medical comorbidity and in 62 healthy controls. Heart rate variability was measured from electrocardiography under a standardized 30 minutes resting state condition. Age, sex, BMI, smoking, alcohol consumption and caffeine consumption as potential confounders were also assessed.

Results:

Heart rate variability (SDNN) was significantly lower in patients with bipolar disorders compared to healthy controls (35.4 msec versus 60.7 msec; P < 0.0001), whereas the Omega-3 Index did not differ significantly between the groups (5.2% versus 5.3%). In a linear regression model, only group membership (patients with bipolar disorders versus healthy controls) and age significantly predicted heart rate variability (SDNN).

Conclusion:

Heart rate variability (SDNN) may provide a useful tool to study the impact of interventions aimed at reducing the increased risk of cardiovascular disease in euthymic patients with bipolar disorders. The difference in SDNN between cases and controls cannot be explained by a difference in the Omega-3 Index.

Keywords

Bipolar disorderHeart rate variabilityOmega-3 IndexCardiovascular disease
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 2 , February 2015 , pp. 228 - 232
Copyright
Copyright © Elsevier Masson SAS 2014

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References

Ali, S., Garg, S.K., Cohen, B.E., Bhave, P., Harris, W.S., Whooley, M.A.Association between omega-3 fatty acids and depressive symptoms among patients with established coronary artery disease: data from the Heart and Soul Study. Psychother Psychosom 2009;78 (2):125–127.CrossRefGoogle ScholarPubMed
Amin, A.A., Menon, R.A., Reid, K.J., Harris, W.S., Spertus, J.A.Acute coronary syndrome patients with depression have low blood cell membrane omega-3 fatty acid levels. Psychosom Med 2008;70 (8):856–862.CrossRefGoogle ScholarPubMed
Baghai, T.C., Varallo-Bedarida, G., Born, C., Hafner, S., Schule, C., Eser, D., et al.Major depressive disorder is associated with cardiovascular risk factors and low Omega-3 Index. J Clin Psychiatry 2011;72 (9):1242–1247.CrossRefGoogle ScholarPubMed
Berridge, M.J.Dysregulation of neural calcium signaling in Alzheimer disease, bipolar disorder and schizophrenia. Prion 2013;7 (1):2–13.CrossRefGoogle Scholar
Buccelletti, E., Gilardi, E., Scaini, E., Galiuto, L., Persiani, R., Biondi, A., et al.Heart rate variability and myocardial infarction: systematic literature review and meta-analysis. Eur Rev Med Pharmacol Sci 2009;13 (4):299–307.Google Scholar
Carney, R.M., Freedland, K.E., Veith, R.C.Depression, the autonomic nervous system, and coronary heart disease. Psychosom Med 2005;67 (Suppl 1):S29–S33.CrossRefGoogle ScholarPubMed
Carney, R.M., Freedland, K.E., Stein, P.K., Steinmeyer, B.C., Harris, W.S., Rubin, E.H., et al.Effect of omega-3 fatty acids on heart rate variability in depressed patients with coronary heart disease. Psychosom Med 2010;72 (8):748–754.CrossRefGoogle ScholarPubMed
Chang, H.A., Chang, C.C., Tzeng, N.S., Kuo, T.B., Lu, R.B., Huang, S.Y.Heart rate variability in unmedicated patients with bipolar disorder in the manic phase. Psychiatry Clin Neurosci 2014;68 (9):674–682.CrossRefGoogle ScholarPubMed
Chen, P.S., Tan, A.Y.Autonomic nerve activity and atrial fibrillation. Heart Rhythm 2007;4 (3 Suppl):S61–S64.CrossRefGoogle ScholarPubMed
Christensen, J.H.Omega-3 polyunsaturated fatty acids and heart rate variability. Front Physiol 2011;2 :84.CrossRefGoogle ScholarPubMed
Cohen, H., Kaplan, Z., Kotler, M., Mittelman, I., Osher, Y., Bersudsky, Y.Impaired heart rate variability in euthymic bipolar patients. Bipolar Disord 2003;5 (2):138–143.CrossRefGoogle ScholarPubMed
CPS GmbH. ProSciCard III. 12 –11–2009. Ref Type: Online Source.Google Scholar
Eschweiler, G.W., Bartels, M., Langle, G., Wild, B., Gaertner, I., Nickola, M.Heart-rate variability (HRV) in the ECG trace of routine EEGs: fast monitoring for the anticholinergic effects of clozapine and olanzapine?. Pharmacopsychiatry 2002;35 (3):96–100.CrossRefGoogle ScholarPubMed
Grosso, G., Pajak, A., Marventano, S., Castellano, S., Galvano, F., Bucolo, C., et al.Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PLoS One 2014;9 (5):e96905.CrossRefGoogle ScholarPubMed
Harris, W.S., von, S.C.The Omega-3 Index: a new risk factor for death from coronary heart disease?. Prev Med 2004;39 (1):212–220.CrossRefGoogle ScholarPubMed
Huikuri, H.V., Stein, P.K.Heart rate variability in risk stratification of cardiac patients. Prog Cardiovasc Dis 2013;56 (2):153–159.CrossRefGoogle ScholarPubMed
Jan, W.C., Yang, S.Y., Chuang, L.C., Lu, R.B., Lu, M.K., Sun, H.S., et al.Exploring the associations between genetic variants in genes encoding for subunits of calcium channel and subtypes of bipolar disorder. J Affect Disord 2014;157 :80–86.CrossRefGoogle ScholarPubMed
Janney, C.A., Fagiolini, A., Swartz, H.A., Jakicic, J.M., Holleman, R.G., Richardson, C.R.Are adults with bipolar disorder active? Objectively measured physical activity and sedentary behavior using accelerometry. J Affect Disord 152–4 2 2014 498–504.CrossRefGoogle Scholar
Kilbourne, A.M., Goodrich, D.E., Lai, Z., Post, E.P., Schumacher, K., Nord, K.M., et al.Randomized controlled trial to assess reduction of cardiovascular disease risk in patients with bipolar disorder: the Self-Management Addressing Heart Risk Trial (SMAHRT). J Clin Psychiatry 2013;74 (7):e655–e662.CrossRefGoogle Scholar
Lala, S.V., Sajatovic, M.Medical and psychiatric comorbidities among elderly individuals with bipolar disorder: a literature review. J Geriatr Psychiatry Neurol 2012;25 (1):20–25.CrossRefGoogle ScholarPubMed
Laursen, T.M.Life expectancy among persons with schizophrenia or bipolar affective disorder. Schizophr Res 2011;131 (1–3):101–104.CrossRefGoogle ScholarPubMed
Lee, J.S., Kim, B., Hong, Y., Joo, Y.H.Heart rate variability in the subsyndromal depressive phase of bipolar disorder. Psychiatry Clin Neurosci 2012;66 (4):361–366.CrossRefGoogle ScholarPubMed
Linder, J.R., Sodhi, S.K., Haynes, W.G., Fiedorowicz, J.G.Effects of antipsychotic drugs on cardiovascular variability in participants with bipolar disorder. Hum Psychopharmacol 2014;29 (2):145–151.CrossRefGoogle ScholarPubMed
Mann, K., Rossbach, W., Muller, M.J., Muller-Siecheneder, F., Ru, H., Dittmann, R.W.Heart rate variability during sleep in patients with schizophrenia treated with olanzapine. Int Clin Psychopharmacol 2004;19 (6):325–330.CrossRefGoogle ScholarPubMed
Merikangas, K.R., Jin, R., He, J.P., Kessler, R.C., Lee, S., Sampson, N.A., et al.Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry 2011;68 (3):241–251.CrossRefGoogle ScholarPubMed
Moon, E., Lee, S.H., Kim, D.H., Hwang, B.Comparative study of heart rate variability in patients with schizophrenia, bipolar disorder, post-traumatic stress disorder, or major depressive disorder. Clin Psychopharmacol Neurosci 2013;11 (3):137–143.CrossRefGoogle ScholarPubMed
Mozaffarian, D., Stein, P.K., Prineas, R.J., Siscovick, D.S.Dietary fish and omega-3 fatty acid consumption and heart rate variability in US adults. Circulation 2008;117 (9):1130–1137.CrossRefGoogle ScholarPubMed
Persons, J.E., Robinson, J.G., Ammann, E.M., Coryell, W.H., Espeland, M.A., Harris, W.S., et al.Omega-3 fatty acid biomarkers and subsequent depressive symptoms. Int J Geriatr Psychiatry 2014;29 (7):747–757.CrossRefGoogle ScholarPubMed
Pfennig, A., Bschor, T., Baghai, T., Braunig, P., Brieger, P., Falkai, P., et al.[S3 guidelines on diagnostics and therapy of bipolar disorders: development process and essential recommendations]. Nervenarzt 2012;83 (5):568–586.CrossRefGoogle Scholar
Pottala, J.V., Talley, J.A., Churchill, S.W., Lynch, D.A., von, S.C., Harris, W.S.Red blood cell fatty acids are associated with depression in a case-control study of adolescents. Prostaglandins Leukot Essent Fatty Acids 2012;86 (4–5):161–165.CrossRefGoogle Scholar
Sarris, J., Mischoulon, D., Schweitzer, I.Omega-3 for bipolar disorder: meta-analyses of use in mania and bipolar depression. J Clin Psychiatry 2012;73 (1):81–86.CrossRefGoogle ScholarPubMed
Schueller, P.O., Feuring, M., Sharkova, Y., Grimm, W., Christ, M.Effects of synthetic progestagens on autonomic tone, neurohormones and C-reactive protein levels in young healthy females in reproductive age. Int J Cardiol 2006;111 (1):42–48.CrossRefGoogle ScholarPubMed
Severus, W.E., Ahrens, B., Stoll, A.L.Omega-3 fatty acids: the missing link?. Arch Gen Psychiatry 1999;56 (4):380–381.CrossRefGoogle ScholarPubMed
Slomka, J.M., Piette, J.D., Post, E.P., Krein, S.L., Lai, Z., Goodrich, D.E., et al.Mood disorder symptoms and elevated cardiovascular disease risk in patients with bipolar disorder. J Affect Disord 2012;138 (3):405–408.CrossRefGoogle ScholarPubMed
Soreca, I., Fagiolini, A., Frank, E., Houck, P.R., Thompson, W.K., Kupfer, D.J.Relationship of general medical burden, duration of illness and age in patients with bipolar I disorder. J Psychiatr Res 2008;42 (11):956–961.CrossRefGoogle ScholarPubMed
Sublette, M.E., Ellis, S.P., Geant, A.L., Mann, J.J.Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J Clin Psychiatry 2011;72 (12):1577–1584.CrossRefGoogle ScholarPubMed
Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996;17 (3):354–381.CrossRefGoogle Scholar
Tomson, T., Ericson, M., Ihrman, C., Lindblad, L.E.Heart rate variability in patients with epilepsy. Epilepsy Res 1998;30 (1):77–83.CrossRefGoogle ScholarPubMed
Valenza, G., Citi, L., Gentili, C., Lanata, A., Scilingo, E.P., Barbieri, R.Point-process nonlinear autonomic assessment of depressive states in bipolar patients. Methods Inf Med 2014;53 (4):296–302.Google ScholarPubMed
von, S.C.Omega-3 index and cardiovascular health. Nutrients 2014;6 (2):799–814.Google Scholar
Voss, A., Baier, V., Schulz, S., Bar, K.J.Linear and nonlinear methods for analyses of cardiovascular variability in bipolar disorders. Bipolar Disord 2006;8 (5 Pt 1):441–452.CrossRefGoogle ScholarPubMed
Weiner, M., Warren, L., Fiedorowicz, J.G.Cardiovascular morbidity and mortality in bipolar disorder. Ann Clin Psychiatry 2011;23 (1):40–47.Google ScholarPubMed
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