Cited by 291Cardiac Health and Mental HealthHeart Rate Variability and Autonomic ControlTreatment of Major Depression

Sympathetic activity in major depressive disorder: identifying those at increased cardiac risk?

Barton, David A, Dawood, Tye, Lambert, Elisabeth A, Esler, Murray D, Haikerwal, Deepak, Brenchley, Celia, Socratous, Florentia, Kaye, David M +3 more·2007·Journal of Hypertension

Abstract

BACKGROUND: Evidence exists linking major depressive disorder (MDD) with clinical cardiovascular events. The importance of the sympathetic nervous system in the generation of cardiac risk in other contexts is established. OBJECTIVE: To examine the importance of the sympathetic nervous system in the generation of cardiac risk in patients with major depressive disorder (MDD). METHODS: Studies were performed in 39 patients meeting the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria for MDD and in 76 healthy subjects. Treatment for patients consisted of selective serotonin reuptake inhibition (SSRI) for 12 weeks. Whole body and cardiac sympathetic activity were examined using noradrenaline isotope dilution methodology and sympathetic nerve recording techniques. Measurement of the extraction of infused tritiated noradrenaline by the heart, and estimation of cardiac dihydroxyphenylglycol production provided direct quantification of neuronal noradrenaline reuptake. RESULTS: Sympathetic activity, particularly in the heart and for the whole body, in patients with MDD followed a bimodal distribution. Elevated values were observed in patients with co-morbid panic disorder (P = 0.006). Consistent with a defect in noradrenaline reuptake, the cardiac extraction of tritiated noradrenaline (0.80 +/- 0.01 versus 0.56 +/- 0.04%, P < 0.001) and cardiac dihydroxyphenylglycol overflow (109 +/- 8 versus 73 +/- 11, P = 0.01) were reduced in patients with MDD. SSRI therapy abolished the excessive sympathetic activation, with whole body noradrenaline spillover falling from 518 +/- 83 to 290 +/- 41 ng/min (P = 0.008). CONCLUSIONS: We have identified a subset of patients with MDD in whom sympathetic nervous activity is extraordinarily high, including in the sympathetic outflow to the heart. Treatment with an SSRI may reduce sympathetic activity in a manner likely to reduce cardiac risk.

Integrity signals

Registry

Crossref · 10.1097/hjh.0b013e32829baae7

Cites

46 of 46 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

2 of the 48 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Authors
Barton, D. A., Dawood, T., Lambert, E. A., Esler, M. D., Haikerwal, D., Brenchley, C., Socratous, F., Kaye, D. M., Schlaich, M. P., Hickie, I., & Lambert, G. W.
Affiliations
  • The Alfred Hospital (AU)
  • Baker Heart and Diabetes Institute (AU)
  • The University of Sydney (AU)
Corresponding author
Lambert, Gavin W
Venue
Journal of Hypertension
Published
2007-10
Volume
25
Issue
10
Pages
2117-2124
ISSN
0263-6352 (ISSN-L)
OpenAlex
W2011292063
Cited by
291
References
48
Citations by year
2026: 5 · 2025: 4 · 2024: 10 · 2023: 14 · 2022: 19 · 2021: 13 · 2020: 7 · 2019: 13 · 2018: 16 · 2017: 14 · 2016: 27 · 2015: 21 · 2014: 16 · 2013: 22 · 2012: 22
FWCI
10.80
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Funders
Monash University
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
major depressive disorder, sympathetic nervous system, heart disease risk, noradrenaline spillover, cardiac sympathetic activity, norepinephrine uptake, dihydroxyphenylglycol, selective serotonin reuptake inhibitors
MeSH terms
Adult, Cardiovascular Diseases, Depressive Disorder, Major, Major Depressive Disorder, Female, Heart, Humans, Male, Middle Aged, Norepinephrine, Sympathetic Nervous System, Case-Control Studies, Panic Disorder, Selective Serotonin Reuptake Inhibitors

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review