Psychiatry Research
Volume 121, Issue 2 , Pages 185-196 , 1 December 2003

Heart rate and QT interval variability: abnormal alpha-2 adrenergic function in patients with panic disorder

  • Vikram Kumar Yeragani

      Affiliations

    • Corresponding Author InformationCorresponding author. Present address: Apt 103, Embassy Orchid, No 38, 6 Cross, 8 Main, RMV Extn, Sadashiva Nagar, Bangalore 5600080, India. Tel.: +91-80-3610507; fax: +91-80-3616804
    • ,
  • Manuel Tancer
    • ,
  • Thomas Uhde

Received 27 August 2002 ,Revised 30 July 2003 ,Accepted 20 August 2003.

References 

  1. Abelson JL, Glitz D, Cameron OG, Lee MA, Bronzo M, Curtis GC. Blunted growth hormone response to clonidine in patients with generalized anxiety disorder. Archives of General Psychiatry. 1991;48:157–162
  2. Abelson JL, Glitz D, Cameron OG, Lee MA, Bronzo M, Curtis GC. Endocrine, cardiovascular, and behavioral responses to clonidine in patients with panic disorder. Biological Psychiatry. 1992;32:18–25
  3. Akselrod S, Gordon D, Ubel FA, Shannon DC, Barger AC, Cohen RJ. Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science. 1981;213:220–222
  4. Atiga WL, Calkins H, Lawrence JH, Tomaselli GF, Smith JM, Berger RD. Beat-to-beat repolarization lability identifies patients at risk for sudden cardiac death. Journal of Cardiovascular Electrophysiology. 1998;9:899–908
  5. Atiga WL, Fananpazir L, McAreavey D, Calkins H, Berger RD. Temporal repolarization lability in hypertensive cardiomyopathy caused by beta-chain heavy gene mutations. Circulation. 2000;101:1237–1242
  6. Berger RD, Akselrod S, Gordon D, Cohen RJ. An efficient algorithm for spectral analysis of heart rate variability. IEEE Transactions in Biomedical Engineering. 1986;33:900–904
  7. Berger RD, Kasper EK, Baughman KL, Marban E, Calkins H, Tomaselli GF. Beat-to-beat QT interval variability. Novel evidence for repolarization lability in ischemic and non-ischemic dilated cardiomyopathy. Circulation. 1997;96:1557–1565
  8. Bigger JT, Fleiss JL, Steinman R, Rolnitzky LM, Kleiger RE, Rottman JN. Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation. 1992;85:164–171
  9. Binah O, Rosen M. Mechanisms of ventricular arrhythmias. Circulation. 1992;85(Supp1 I):I25–I31
  10. Bonnemeier H, Hartmann F, Uwe KH, Bode F, Katus HA, Richardt G. Course and prognostic implications of QT interval and QT interval variability after primary coronary angioplasty in acute myocardial infarction. Journal of the American College of Cardiology. 2001;37:44–50
  11. Cameron OG, Smith CB, Lee MA, Hollingsworth PJ, Hill EM, Curtis GC. Adrenergic status in anxiety disorders: platelet alpha-2 adrenergic binding, blood pressure, pulse and plasma catecholamines in panic and generalized anxiety disorder patients and in normal subjects. Biological Psychiatry. 1990;28:3–20
  12. Charney DS, Redmond DE. Neurobiological mechanisms in human anxiety. Neuropharmacology. 1983;22:1531–1536
  13. Charney DS, Heninger GR, Sternberg DE, Hafstad KM, Giddings S, Landis DH. Adrenergic receptor sensitivity in depression: effects of clonidine in depressed patients and healthy subjects. Archives of General Psychiatry. 1982;39:290–294
  14. Charney DS, Heninger GR, Breier A. Noradrenergic function in panic anxiety. Archives of General Psychiatry. 1984;41:751–763
  15. Charney DS, Woods SW, Heninger GR. Noradrenergic function in generalized anxiety disorder: effects of yohimbine in healthy subjects and patients with generalized anxiety disorder. Psychiatry Research. 1989;27:173–182
  16. Coplan JD, Rosenblum , Leonard A, Friedman S, Basoff , Trina B, et al. Behavioral effects of oral yohimbine in differentially reared nonhuman primates. Neuropsychopharmacology. 1992;6:31–37
  17. Coryell W, Noyes R, House JD. Mortality among outpatients with anxiety disorders. American Journal of Psychiatry. 1986;143:508–510
  18. DiCarlo SE, Collins HL, Rodenbaugh DR, Smitha MR, Berger RD, Yeragani VK. Daily exercise reduces blood pressure variability measures in hypertensive rats. Journal of Clinical and Experimental Hypertension. 2002;24:221–234
  19. Dinca-Panaitescu S, Dinca-Panaitescu M, Achim A, Negoescu R. Idioventricular low frequency oscillation in QT interval responds univocally to RR confusing kinds of mental stress. Integrative Physiology and Behavioral Science. 1999;34:10–18
  20. Elghozi JL, Janvier F, Laude D. Clonidine reduces blood pressure and heart rate oscillations in hypersensitive patients. Journal of Cardiovascular Pharmacology. 1991;17:935–940
  21. Girgis I, Chakko S, de Marchena E, Jara C, Diaz P, Castellanos A, et al. Effect of clonidine on heart rate variability in congestive heart failure. American Journal of Cardiology. 1998;82:335–337
  22. Grichois M, Japundzic N, Head GA, Elghozi J. Clonidine reduces blood pressure and heart rate oscillations in the conscious rat. Journal of Cardiovascular Pharmacology. 1990;16:449–454
  23. Gurguis G, Uhde TW. Plasma 3-methoxy-4-hydroxyphenylethylene glycol (MHPG) and growth hormone responses to yohimbine in panic disorder patients and normal controls. Psychoneuroendocrinology. 1990;15:217–224
  24. Gurguis GN, Vittone BJ, Uhde TW. Behavioral, sympathetic and adrenocortical responses to yohimbine in panic disorder patients and normal controls. Psychiatry Research. 1997;167(71):27–39
  25. Holmberg G, Gershon S. Autonomic and psychic effects of yohimbine hydrochloride. Psychopharmacologia. 1961;2:93–106
  26. Jervell A, Lange-Nelson F. Congenital deaf mutism, functional heart disease with prolongation of the QT interval, and sudden death. American Heart Journal. 1957;54:59–68
  27. Kawachi I, Sparrow D, Vokonas PS, Weiss ST. Symptoms of anxiety and risk of coronary heart disease: the normative aging study. Circulation. 1994;90:2225–2229
  28. Kleiger RE, Miller JP, Bigger JT, Moss AJ. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. American Journal of Cardiology. 1987;59:256–262
  29. Lazzeri C, La Villa G, Mannelli M, Janni L, Franchi F. Effects of acute clonidine administration on power spectral analysis of heart rate variability in healthy humans. Journal of Autonomic Pharmacology. 1998;18:307–312
  30. Lazzeri C, La Villa G, Mannelli M, Janni L, Barletta G, Montano N, et al. Effects of clonidine on power spectral analysis of heart rate variability in mild essential hypertension. Autonomic Nervous System. 1998;11:152–159
  31. Malik M, Camm AJ. Heart rate variability. Clinical Cardiology. 1990;13:570–576
  32. Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation. 1991;84:482–492
  33. Molgaard H, Sorensen KE, Bjerregard P. Attenuated 24-hour heart rate variability in apparently healthy subjects, subsequently suffering sudden cardiac death. Clinical Autonomic Research. 1991;1:233–237
  34. Murabayashi T, Fetics B, Kass D, Nevo E, Gramatikov B, Berger RD. Beat-to-beat QT interval variability associated with acute myocardial ischemia. Journal of Electrocardiology. 2002;35:19–25
  35. Negoescu R, Dinca-Panaitescu S, Filscescu V, Ionescu D, Wolf S. Mental stress enhances the sympathetic fraction of QT variability in an R-R independent way. Integrative Physiology and Behavioral Science. 1997;32:220–227
  36. Piccirillo G, Cacciafesta M, Lionetti M, Nocco M, Giuseppe V, Moise A, et al. Influence of age, the autonomic nervous system and anxiety on QT-interval variability. Clinical Science (London). 2001;101:429–438
  37. Pohl R, Yeragani VK. QT interval variability in panic disorder patients after isoproterenol infusions. International Journal of Neuropsychopharmacology. 2001;4:17–20
  38. Pohl R, Balon R, Jayaraman A, Doll R, Yeragani VK. Effect of fluoxetine, pemoline and placebo on heart period variability and QT interval variability in normal humans. Journal of Psychosomatic Research. 2003;55:247–251
  39. Pomeranz B, Macaulay RJB, Caudill MA, Kutz I, Adam D, Gordon D, et al. Assessment of autonomic function in humans by heart rate spectral analysis. American Journal of Physiology. 1985;248:H151–H153
  40. Radhakrishna RKA, Yeragani VK. Decreased measures of chaos and increased nonlinearity in patients with panic disorder. Autonomic Neuroscience. 2001;88:99–108
  41. Redmond DE, Huang YH, Snyder DR, Mass JW. Behavioral effects of stimulation of the nucleus locus ceruleus in the stump-tailed monkey. Brain Research. 1976;116:502–510
  42. Schwartz PJ, Wolf S. QT interval prolongation as predictor of sudden death in patients with myocardial infarction. Circulation. 1978;57:1074–1077
  43. Spielberger CD, Gorsuch RL, Luschene RE. State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970;
  44. Spitzer RL, Williams JBW, Gibbon M. Structured Clinical Interview for DSM-III-R (SCID). New York: New York State Psychiatric Institute; 1987;
  45. Srimal RC, Gulati K, Dhawan BN. On the mechanism of central hypotensive action of clonidine. Canadian Journal of Physiology and Pharmacology. 1977;55:1007–1014
  46. Tomaselli GF, Buckelmann DJ, Calkins HG. Sudden cardiac death in heart failure: the role of abnormal repolarization. Circulation. 1994;90:2534–2539
  47. Uhde TW, Vittone BJ, Siever LJ, Kaye WH, Post RM. Blunted growth hormone response to clonidine in panic disorder patients. Biological Psychiatry. 1986;21:1081–1085
  48. Uhde TW, Stein MB, Vittone BJ, Siever LJ, Boulenger JP, Klein E, et al. Behavioral and physiologic effects of short-term and long-term administration of clonidine in panic disorder. Archives of General Psychiatry. 1989;46:170–177
  49. Vrtovec B, Starc V, Starc R. Beat-to-beat QT interval variability in coronary patients. Journal of Electrocardiology. 2000;33:119–125
  50. Weissmann MW, Markowitz JS, Ouelette R, Greenwald S, Kahn JP. Panic disorder and cardiovascular/cerebrovascular problems. American Journal of Psychiatry. 1990;147:1504–1507
  51. Yeragani VK, Balon R, Pohl R. Lactate infusions in panic disorder patients and normal controls: Autonomic measures and subjective anxiety. Acta Psychiatrica Scandinavica. 1989;79:32–40
  52. Yeragani VK, Balon R, Pohl R, Ramesh C, Glitz D, Weinberg P, et al. Decreased R-R variance in panic disorder patients. Acta Psychiatrica Scandinavica. 1990;81:554–559
  53. Yeragani VK, Berger R, Pohl R, Srinivasan K, Balon R, Ramesh C, et al. Effects of yohimbine on heart rate variability in panic disorder patients and normal controls: a study of power spectral analysis of heart rate. Journal of Cardiovascular Pharmacology. 1992;20:609–618
  54. Yeragani VK, Pohl R, Berger R, Balon R, Ramesh C, Glitz D, et al. Decreased heart rate variability in panic disorder patients: a study of power spectral analysis of heart rate. Psychiatry Research. 1993;46:89–103
  55. Yeragani VK, Srinivasan K, Balon R, Ramesh C, Berchou R. Lactate sensitivity and cardiac cholinergic function in panic disorder. American Journal of Psychiatry. 1994;151:1226–1228
  56. Yeragani VK, Pohl R, Srinivasan K, Balon R, Ramesh C, Berchou R. Effects of isoproterenol on heart rate variability in patients with panic disorder. Psychiatry Research. 1995;56:289–293
  57. Yeragani VK, Sobolewski E, Igel G, Johnson C, Jampala VC, Kay J, et al. Decreased heart period variability in patients with panic disorder: a study of Holter ECG records. Psychiatry Research. 1998;78:89–99
  58. Yeragani VK, Nadella R, Hinze B, Yeragani S, Jampala VC. Nonlinear measures of heart period variability: decreased measures of symbolic dynamics in patients with panic disorder. Depression and Anxiety. 2000;12:67–77
  59. Yeragani VK, Pohl R, Jampala VC, Balon R, Kay J, Igel G. Effect of posture and isoproterenol on beat-to-beat heart rate and QT variability. Neuropsychobiology. 2000;41:113–123
  60. Yeragani VK, Pohl R, Jampala VC, Balon R, Ramesh C, Srinivasan K. Increased QT variability in patients with panic disorder and depression. Psychiatry Research. 2000;93:225–235
  61. Yeragani VK, Pohl R, Jampala VC, Balon R, Ramesh C. Effect of age on QT variability. Pediatric Cardiology. 2000;21:411–415
  62. Yeragani VK, Pohl R, Balon R, Jampala VC, Jayaraman A. Increased 24-hour QT interval variability during sleep in patients with panic disorder. Neuropsychobiology. 2000;46:111–120

PII: S0165-1781(03)00235-X

doi: 10.1016/S0165-1781(03)00235-X

Psychiatry Research
Volume 121, Issue 2 , Pages 185-196 , 1 December 2003

Article Tools

* Image Usage & Resolution