Cited by 192Heart Rate Variability and Autonomic ControlPosttraumatic Stress Disorder ResearchCardiac Health and Mental Health

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Posttraumatic Stress Disorder and Impaired Autonomic Modulation in Male Twins

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Shah, Amit J., Lampert, Rachel, Goldberg, Jack, Veledar, Emir, Bremner, J. Douglas, Vaccarino, Viola·2013·Biological Psychiatry

DOI 10.1016/j.biopsych.2013.01.019PMC PMC3648627

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Abstract

Background Posttraumatic stress disorder (PTSD) has been linked to increased morbidity. An inflexibility of the autonomic nervous system might be the underlying mechanism. We aimed to assess whether PTSD and combat trauma exposure are associated with lower heart rate variability (HRV), a measure of autonomic function and a predictor of death.Methods We measured HRV by power spectral analysis on 24-hour ambulatory electrocardiogram in 459 middle-aged veteran male twins. Combat trauma was assessed with the combat exposure scale, and current and remitted PTSD was assessed with the Structured Clinical Interview for Psychiatry Disorders. Mixed-effects regression models were used to test associations of PTSD and HRV between and within twin pairs.Results Of all twins, 211 had combat exposure, 31 had current PTSD, and 43 had remitted PTSD. Current PTSD was inversely associated with very-low-frequency and low-frequency HRV both in individual twins and within 20 pairs discordant for current PTSD. Twins with current PTSD had a 49% lower low-frequency HRV than their brothers without PTSD (p<.001). Remitted PTSD was not associated with HRV. Results were robust to adjustment for depression and other risk factors. Combat exposure was inversely associated with most HRV frequencies, but this association mostly diminished after adjustment for current PTSD.Conclusion In middle-aged veteran men, combat exposure and current PTSD are associated with measures of autonomic inflexibility previously shown to have prognostic significance. The negative health impact of combat exposure on autonomic function is mediated largely through PTSD and might reverse with remission of PTSD.

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Authors: Shah, A. J., Lampert, R., Goldberg, J., Veledar, E., Bremner, J. D., & Vaccarino, V.
Affiliations: Emory University (US)
Yale University (US)
University of Washington (US)
Atlanta VA Medical Center (US)
Corresponding author: Vaccarino, Viola
ORCID: Shah, Amit J.
Lampert, Rachel
Goldberg, Jack
Veledar, Emir
Bremner, J. Douglas
Vaccarino, Viola
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2013-06
Volume: 73
Issue: 11
Pages: 1103-1110
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2013.01.019
PMC: PMC3648627
OpenAlex: W1968036378
Cited by: 192
References: 55
Citations by year: 2026: 6 · 2025: 9 · 2024: 12 · 2023: 13 · 2022: 12 · 2021: 21 · 2020: 17 · 2019: 19 · 2018: 13 · 2017: 19 · 2016: 21 · 2015: 11 · 2014: 15 · 2013: 4
FWCI: 11.43
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Florida International University Digital Commons (Florida International University) (submittedVersion)
Funders: National Institutes of Health (UL1TR000454)
National Institute on Aging (R01AG026255)
National Heart, Lung, and Blood Institute (R01HL068630, K24HL077506, R21HL093665, R01HL088726)
National Institute of Mental Health (R01MH056120, K24MH076955)
National Center for Research Resources (M01RR000039)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords: post-traumatic stress disorder, heart rate variability, autonomic nervous system, veterans, twin discordance, middle-aged men, Holter monitoring
MeSH terms: Combat Disorders, Diseases in Twins, Heart Rate, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Regression Analysis, Stress Disorders, Post-Traumatic, Veterans, Electrocardiography, Ambulatory

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Posttraumatic Stress Disorder and Impaired Autonomic Modulation in Male Twins

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