The DOI matches its Crossref record; 46 of the 48 references it cites were found in a registry or an index.
Sympathetic activity in major depressive disorder: identifying those at increased cardiac risk?
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.
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“Conversely, with the coexistence of impaired norepinephrine reuptake with firing salvos in normal-weight essential hypertension 31,[33][34][35][36] and in depressive illness 42,51,79 and panic disorder, 51,79,80 there is evidence of cardiac risk, 84 even in panic disorder.[85][86][87]”
From Obesity Paradox in Hypertension: Is This Because Sympathetic Activation in Obesity-Hypertension Takes a Benign Form? (2018) · cites this paper as [42]
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“The ranking is as follows: for cardiac sympathetic activation, cardiac failure>normal-weight essential hypertension>depressive ill ness>aging.19,22,24,42,44,45,49,78”
From Obesity Paradox in Hypertension: Is This Because Sympathetic Activation in Obesity-Hypertension Takes a Benign Form? (2018) · cites this paper as [42]
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Self-citation
Research works printed but not linked: 1
- Meredith, 1991, Evidence of a selective increase in cardiac sympathetic activity in patients with sustained ventricular arrhythmias, N Engl J Med, 325, 618, 10.1056/NEJM199108293250905 · DOI · Paper page
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Penninx, B. W., Milaneschi, Y., Lamers, F., & Vogelzangs, N. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-129 · Cited by 839
Meng, L., Chen, D., Yang, Y., Zheng, Y., & Hui, R. (2012) · Journal of Hypertension · doi:10.1097/hjh.0b013e32835080b7 · Cited by 526
Grippo, A. J., & Johnson, A. K. (2009) · Stress · doi:10.1080/10253890802046281 · Cited by 464
Lim, M. H., Eres, R., & Vasan, S. (2020) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-020-01889-7 · Cited by 438
Depression and the Link with Cardiovascular Disease
Dhar, A. K., & Barton, D. A. (2016) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2016.00033 · Cited by 431
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Metadata
- 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
- Semantic Scholar
- 11e1e7e034e6fb95be3ea0d1bee0214d1fc79e11
- 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 (medical) › 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
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