Background

Bipolar disorder (BD) is associated with premature death and ischemic heart disease is the main cause of excess mortality. Heart rate variability (HRV) predicts mortality in patients with or without cardiovascular disease. While several studies have analyzed the association between HRV and BD, none has analyzed the association of HRV with illness burden in BD.

Methods

53 participants with BD I and II used a wearable device to assess the association between HRV and factors characterizing illness burden, including illness duration, number and type of previous episode(s), duration of the most severe episode, history of suicide attempts or psychotic symptoms during episodes, and co-morbid psychiatric disorders. We ran unadjusted models and models controlling statistically for age, sex, pharmacotherapy, baseline functional cardiovascular capacity, BMI, years of education, and marital status.

We also explored the association between HRV and an overall illness burden index (IBI) integrating all these factors using a weighted geometric mean.

Results

Adjusted and unadjusted models had similar results. Longer illness duration, higher number of depressive episodes, longer duration of most severe manic/hypomanic episode, co-morbid anxiety disorders, and family history of suicide were associated with reduced HRV, as was bipolar depression severity in the participants experiencing a depressive episode. Finally, a higher IBI score was associated with lower HRV.

Conclusions

High illness burden is associated with reduced HRV in BD. While the IBI needs to be validated in a larger sample, it may provide an overall measure that captures illness burden in BD.

中文翻译：

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心率变异性降低与双相情感障碍更高的疾病负担相关

背景

双相情感障碍 (BD) 与过早死亡有关，缺血性心脏病是死亡率过高的主要原因。心率变异性 (HRV) 可预测患有或不患有心血管疾病的患者的死亡率。虽然有几项研究分析了 HRV 与 BD 之间的关联，但没有一项研究分析了 HRV 与 BD 疾病负担的关联。

方法

53 名患有 BD I 和 II 的参与者使用可穿戴设备来评估 HRV 与表征疾病负担的因素之间的关联，包括疾病持续时间、先前发作的次数和类型、最严重发作的持续时间、自杀未遂史或精神病史发作期间的症状，以及并存的精神障碍。我们运行未调整的模型和模型，对年龄、性别、药物治疗、基线功能性心血管能力、BMI、受教育年限和婚姻状况进行统计控制。

我们还使用加权几何平均值探讨了 HRV 与综合所有这些因素的整体疾病负担指数 (IBI) 之间的关联。

结果

调整和未调整的模型具有相似的结果。疾病持续时间越长、抑郁发作次数越多、最严重的躁狂/轻躁狂发作持续时间越长、共病焦虑症和自杀家族史都与 HRV 降低有关，经历抑郁发作的参与者的双相抑郁严重程度也是如此。最后，较高的 IBI 评分与较低的 HRV 相关。

结论

高疾病负担与 BD 的 HRV 降低有关。虽然 IBI 需要在更大的样本中进行验证，但它可以提供一个全面的衡量标准，以捕捉 BD 中的疾病负担。