Relationship Between Depression and Subclinical LV Changes
There were 2420 middle-aged participants in the study, all of whom were free of overt CVD except hypertension or diabetes mellitus. Among them, 1732 participants had no depression, 547 had mild depression, and 141 had moderate to severe depression. Demographic and clinical characteristics of the study participants are described in Table 1. Participants with moderate to severe depression were older, had lower diastolic BP, and included more women than the other groups. Although the proportion of established cases of diabetes mellitus did not differ among the groups, more participants with moderate to severe depression were on antidiabetic medication as compared with the other groups. Fasting serum insulin concentrations were also higher in participants with moderate to severe depression. There were no significant differences in hsCRP values and prevalence of metabolic syndrome, according to level of depression (Table 1).
Participants with moderate to severe depression had a higher transmitral A wave velocity, lower E/A ratio, lower TDI Ea and higher Aa velocities, and higher E/Ea ratio (Table 2). Table 3 presents the multivariate-adjusted echocardiographic data. There were no significant differences in transmitral A wave velocity, E/A ratio and TDI Aa velocity among the study groups. On the other hand, TDI Ea velocity consistently showed statistically significant differences across depression levels after adjusting for age, sex, body mass index, heart rate, mean arterial pressure, fasting blood glucose, hsCRP, antihypertensive medication and antidiabetic medication (p=0.006 vs no depression, p=0.028 vs mild depression) (figure 1). Participants with moderate to severe depression also had higher LV mass indices than participants without depression (p=0.017) (figure 1 and Table 3).
(Enlarge Image)
Figure 1.
Multivariate-adjusted mean values, and 95% CIs of LV structural and diastolic functional variables, by classification of depression after adjustment for age, sex, body mass index, heart rate, mean arterial pressure, fasting blood glucose, hsCRP, antihypertensive medication and antidiabetic medication. hsCRP, high-sensitivity C reactive protein; LVMI, left ventricular mass index; TDI, tissue Doppler imaging.
In the linear regression models, the presence of depression (BDI-I ≥10) was independently associated with TDI Ea velocity after adjusting for age, sex, body mass index, heart rate, mean arterial pressure, fasting blood glucose, hsCRP, antihypertensive medication and antidiabetic medication (Table 4).
Results
There were 2420 middle-aged participants in the study, all of whom were free of overt CVD except hypertension or diabetes mellitus. Among them, 1732 participants had no depression, 547 had mild depression, and 141 had moderate to severe depression. Demographic and clinical characteristics of the study participants are described in Table 1. Participants with moderate to severe depression were older, had lower diastolic BP, and included more women than the other groups. Although the proportion of established cases of diabetes mellitus did not differ among the groups, more participants with moderate to severe depression were on antidiabetic medication as compared with the other groups. Fasting serum insulin concentrations were also higher in participants with moderate to severe depression. There were no significant differences in hsCRP values and prevalence of metabolic syndrome, according to level of depression (Table 1).
Participants with moderate to severe depression had a higher transmitral A wave velocity, lower E/A ratio, lower TDI Ea and higher Aa velocities, and higher E/Ea ratio (Table 2). Table 3 presents the multivariate-adjusted echocardiographic data. There were no significant differences in transmitral A wave velocity, E/A ratio and TDI Aa velocity among the study groups. On the other hand, TDI Ea velocity consistently showed statistically significant differences across depression levels after adjusting for age, sex, body mass index, heart rate, mean arterial pressure, fasting blood glucose, hsCRP, antihypertensive medication and antidiabetic medication (p=0.006 vs no depression, p=0.028 vs mild depression) (figure 1). Participants with moderate to severe depression also had higher LV mass indices than participants without depression (p=0.017) (figure 1 and Table 3).
(Enlarge Image)
Figure 1.
Multivariate-adjusted mean values, and 95% CIs of LV structural and diastolic functional variables, by classification of depression after adjustment for age, sex, body mass index, heart rate, mean arterial pressure, fasting blood glucose, hsCRP, antihypertensive medication and antidiabetic medication. hsCRP, high-sensitivity C reactive protein; LVMI, left ventricular mass index; TDI, tissue Doppler imaging.
In the linear regression models, the presence of depression (BDI-I ≥10) was independently associated with TDI Ea velocity after adjusting for age, sex, body mass index, heart rate, mean arterial pressure, fasting blood glucose, hsCRP, antihypertensive medication and antidiabetic medication (Table 4).
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