Decreased heart-period variability in patients with panic disorder: a study of Holter ECG records

Yeragani, Vikram K.; Sobolewski, E.; Igel, Gina; Johnson, Charles L.; Jampala, V.C.; Kay, Jerald; Hillman, N; Yeragani, Suneetha; Vempati, S.

doi:10.1016/s0165-1781(97)00136-4

Cited by 100 publications

(82 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings should be viewed in the context of our previous findings of decreased HR or HP (heart period) variability in patients with panic disorder compared to control subjects and also the effects of yohimbine, suggesting a relative increase in cardiac vagal function in anxiety (Yeragani et al, 1992(Yeragani et al, , 1993a(Yeragani et al, , 1998. The main findings of this study are that sodium lactate, a drug that induces symptoms of panic anxiety in patients with panic disorder and a minority of normal control subjects, has produced a substantial decrease in LLE of unfiltered time series and also that of HF filtered series, which strongly suggests a vagolytic effect.…”

Section: Discussionmentioning

confidence: 53%

Heart rate time series: decreased chaos after intravenous lactate and increased non-linearity after isoproterenol in normal subjects

Yeragani

Rao

Jayaraman

et al. 2002

Psychiatry Research

View full text Add to dashboard Cite

In this study, we reanalyzed our previous heart rate time series data on the effects of intravenous sodium lactate (ns9) and intravenous isoproterenol (ns11) using non-linear techniques. Our prior findings of significantly higher baseline non-linear scores (NL: S ) and significantly lower largest Lyapunov exponents in supine posture in netGS patients with panic disorder compared to control subjects prompted this study. We obtained the largest Lyapunov exponent (LLE), and a measure of non-linearity (NL: S ) of heart rate time series. LLE quantifies predictability netGS and NL quantifies the deviation from linear processes. There was a significant increase in NL score, (S ) after netGS isoproterenol infusions and a significant decrease in LLE (an increase in predictability indicating decreased chaos), after intravenous lactate in supine posture in normal control subjects. Increased NL scores in supine posture after intravenous isoproterenol may be due to a relative increase in cardiac sympathetic activity or a decrease in vagal activity at least in certain circumstances, and an overall decrease in LLE may indicate an impaired cardiac autonomic flexibility after intravenous sodium lactate, as LLE is diminished by autonomic blockade by atropine. Band analysis of LLE (LFyHF) (LF: 0.04 -0.15 Hz and HF: 0.15 -0.5 Hz) showed an increase of these ratios during either condition with a higher sympathovagal interaction after the drug administration. These findings may throw new light on the association of anxiety and significant cardiovascular events. ᮊ

show abstract

Section: Discussionmentioning

confidence: 53%

Heart rate time series: decreased chaos after intravenous lactate and increased non-linearity after isoproterenol in normal subjects

Yeragani

Rao

Jayaraman

et al. 2002

Psychiatry Research

View full text Add to dashboard Cite

show abstract

“…This increase in cardiovascular/cerebrovascular morbidity and mortality rates may be due to the existence of chronic cardiovascular (CV) risk in PD patients, illustrated either by elevated conventional risk factors such as smoking (Amering et al, 1999) or by chronic physiological states such as a sympathetic predominance as suggested by the decreased heart rate variability consistently described in PD patients (Yeragani et al, 1998). It appears that the increased risk for sudden cardiac death found in patients with high Nitric oxide and panic attacks N Lara et al levels of phobic anxiety, a common feature in PD patients, persists even after correction for conventional risk factors (Kawachi et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary and Systemic Nitric Oxide Measurements During CCK-5-Induced Panic Attacks

Lara

Chrapko

Archer

et al. 2003

Neuropsychopharmacol

View full text Add to dashboard Cite

Nitric oxide (NO) plays a major role in cardiopulmonary regulation as illustrated by the alterations of the NO system described in cardiopulmonary illnesses. Recent studies have found an association between panic disorder and cardiovascular death and illness, as well as pulmonary diseases. Our objective was to investigate whether pulmonary or systemic NO production was altered during induced panic attacks (PAs). We used a double-blind placebo-controlled crossover design with randomization of the order of an injection of placebo and pentagastrin, a cholecystokinin-B receptor agonist that induces PAs in healthy volunteers (HVs). A total of 17 HVs experienced a PA after pentagastrin challenge. Exhaled NO and NO metabolites were measured by chemiluminescence. During pentagastrin-induced PAs, HVs displayed significant decreases in plateau concentrations of NO exhaled, which were associated with proportional increases in minute ventilation. There were no significant changes in pulmonary or systemic NO production. These results suggest that the decrease in exhaled NO concentration observed during pentagastrin-induced PAs is related to the associated hyperventilation, rather than to any change in lung NO production. This study is the first to evaluate changes in NO measurements during acute anxiety.

show abstract

“…Kalp hızı değişkenliğinin uykuda incelenmesi, uyanıklıktaki bozucu dış faktörlerin etkisinden uzak, tonik otonomik işlevin değerlendirilmesinde daha değerli sonuçlar alınmasını sağlayabilir. Ancak panik bozukluğu hastalarında sınırlı sayıdaki uykuda kalp hızı değişkenliği çalışmalarından tutarlı sonuçlar elde edilememiştir (17)(18)(19)(20). Bu nedenle bu çalışmada ilaç kullanmayan panik bozukluğu hastalarının polisomnografi çalışması ile kalp hızı değişkenliğinin zaman ve frekans-alanında analizi amaçlanmıştır.…”

Section: Introductionunclassified

Panik Bozukluğu Hastalarında Uykuda Kalp Hızı Değişkenliği

Yetkin¹,

Erdamar²,

Yokuşoğlu³

et al. 2014

jtsm

View full text Add to dashboard Cite

Summary ÖzetIntroduction: Studies generally indicate that panic disorder patients have reduced heart rate variability (HRV), diminished vagal tone and relative sympathetic dominance. Despite a consistent profile of reduced HRV in PD patients during daytime assessments, sleep-based HRV studies have yielded inconsistent results. For this reason, we aimed to investigate cardiac autonomic function in PD patients using polysomnographic records. Materials and Methods: 15 non-medicated PD patients and 15 ageand sex-matched normal controls were studied on polysomnography on two consecutive nights. Data were extracted from the second night for analysis. Results: Patients showed poor sleep efficiency, increased the number of the awakenings, and longer sleep latency than controls. Comparison of time domain and frequency domain HRV parameters between PD patients and control subjects revealed that there were no statistically significant differences. Discussion: The results indicate that the sympathovagal balance might not be influenced in drug-free patients with panic disorder in the early stage of illness. (JTSM 2014;1:28-32)

show abstract

Decreased heart-period variability in patients with panic disorder: a study of Holter ECG records

Cited by 100 publications

References 41 publications

Heart rate time series: decreased chaos after intravenous lactate and increased non-linearity after isoproterenol in normal subjects

Heart rate time series: decreased chaos after intravenous lactate and increased non-linearity after isoproterenol in normal subjects

Pulmonary and Systemic Nitric Oxide Measurements During CCK-5-Induced Panic Attacks

Panik Bozukluğu Hastalarında Uykuda Kalp Hızı Değişkenliği

Contact Info

Product

Resources

About