P-142 - Heart rate variability spectral analysis in patients with panic disorder compared with healthy controls

Abstract

Power spectral analysis of electrocardiogram is known to be a particularly successful tool in detection of autonomic instabilities in various disorders. The aim of study is to measure very low frequency band (VLF), low frequency band (LF) and high frequency band (HF) components of R-R interval during orthostatic test in patients with panic disorder and a comparison with controls. Methods: We measured HRV in 31 panic disorder patients and 20 healthy controls. Patients were treated with psychotropics. Autonomic nervous system has been evaluated during orthostatic change in three positions (1 st-supine 5 minutes, 2 nd-standing 5 minutes, 3 rd-supine 5 minutes). Intensity of symptoms was assessed using CGI (Clinical Global Impression), BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory), DES (Dissociative Experience Scale). The functioning of the ANS has been measured by the microcomputer diagnostic system that is using power spectral analysis which quantifies the heart rate variability. HRV was assessed using time domain, frequency domain, and nonlinear analyses. Results: There were highly statistically significant differences between panic patients and control group in all components of power spectral analysis in 2 nd and 3 rd VLF components and in HF components of 2 nd of experiment. We have found highly statistically significant negative correlations between level of dissociation measured by DES and some parameters of ANS. Conclusions: Autonomic dysregulation is associated with panic disorder and has the relation with the level of dissociation, the age of patiens and age of onset of disorder.

Neurophysiological correlates of dissociative symptoms

“…The general conclusion is that during hypnosis, HRV increases without a concomitant change in heart rate, suggesting an increase in parasympathetic modulation of cardiac activity 16–18. The two HRV studies that assessed the tendency to dissociate show that a high tendency to dissociate is significantly related to decreased HRV 19 20. This finding corresponds with the results of investigations in patient populations with dissociative symptoms: patients with FNSS demonstrate lower HRV compared with healthy controls 21 22.…”

Physiologic correlates of culture-bound dissociation: A comparative study of Brazilian spiritist mediums and controls

“…and panic disorder (Diveky et al, 2012) show that they may have persistently reduced parasympathetic activity compared to healthy controls. These studies also found an inverse correlation between dissociative symptom scores and parameters of parasympathetic activity.…”

Is panic disorder a disorder of physical fitness? A heuristic proposal

“…Although patients do not have any full-blown cardiac disease, they have imbalanced autonomic regulation, reduced heart rate variability, increased time variability of ventricular repolarization, higher regional heterogeneity of ventricular repolarization and atrial depolarization 25 – 28 , and higher variability of ECG-R wave amplitude after beta-adrenergic stimulation with isoproterenol 29 . PD patients who are normotensive exhibit an impaired circadian blood pressure pattern with an inadequate reduction in nighttime blood pressure (non-dipper pattern) 30 as well as an unstable heart rate while asleep 31 .…”

“…At least in a certain proportion of patients with PD, PAs may be caused by paroxysmal supraventricular tachycardia 32 . In addition, these patients exhibit increased arterial stiffness, and several factors negatively affect endothelial function, such as increased homocysteine levels and platelet aggregation or volume and lower levels of nitric oxide 25 – 28 . Once more, these subtle abnormalities can render the cardiovascular system less efficient, and they are considered cardiovascular risk factors.…”