Yang YP, Ji MJ, Guo YH, Yao N. Association of heart rate variability index with depressive symptoms and lung function in chronic obstructive pulmonary disease. World J Psychiatry 2025; 15(5): 103269 [DOI: 10.5498/wjp.v15.i5.103269]
Corresponding Author of This Article
Na Yao, BM, Doctor, Department of Respiratory and Critical Care Medicine, The First Hospital of Zhangjiakou, No. 6 Jianguo Road, Qiaodong District, Zhangjiakou 075000, Hebei Province, China. 13315342601@163.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. May 19, 2025; 15(5): 103269 Published online May 19, 2025. doi: 10.5498/wjp.v15.i5.103269
Association of heart rate variability index with depressive symptoms and lung function in chronic obstructive pulmonary disease
Ya-Ping Yang, Mei-Jia Ji, Yue-Han Guo, Na Yao
Ya-Ping Yang, Na Yao, Department of Respiratory and Critical Care Medicine, The First Hospital of Zhangjiakou, Zhangjiakou 075000, Hebei Province, China
Mei-Jia Ji, Department of Geriatrics One, The First Hospital of Zhangjiakou, Zhangjiakou 075000, Hebei Province, China
Yue-Han Guo, Department of Psychiatric, Wuhan Mental Health Center, Wuhan 430000, Hubei Province, China
Co-first authors: Ya-Ping Yang and Mei-Jia Ji.
Author contributions: Yang YP and Ji MJ designed the research study; Yang YP, Ji MJ, Guo YH and Yao N performed the research; Yang YP and Yao N collected and analyzed the data; Guo YH and Ji MJ drafted the manuscript; All authors contributed to critical revisions of the manuscript for important intellectual content and gave final approval of the version to be published. Each author has sufficiently participated in the work to take public responsibility for appropriate portions of the content and agreed to be accountable for all aspects of the work in ensuring its accuracy and integrity.
Supported by the Zhangjiakou City Science and Technology Research Plan, No. 1821110D.
Institutional review board statement: This research project has been approved by Ethics Committee of The First Hospital of Zhangjiakou and operated in strict accordance with ethical standards (No. 2024-LW-31).
Informed consent statement: All of the selected patients were informed of the study and provided informed consent to participate.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Na Yao, BM, Doctor, Department of Respiratory and Critical Care Medicine, The First Hospital of Zhangjiakou, No. 6 Jianguo Road, Qiaodong District, Zhangjiakou 075000, Hebei Province, China. 13315342601@163.com
Received: February 7, 2025 Revised: March 5, 2025 Accepted: April 3, 2025 Published online: May 19, 2025 Processing time: 81 Days and 23.9 Hours
Abstract
BACKGROUND
Depression is a common comorbidity in patients with chronic obstructive pulmonary disease (COPD). Research indicates that COPD affects cardiac autonomic control, and heart rate variability (HRV) serves as a simple, non-invasive measure of autonomic nerve activity. However, the relationship between HRV and lung function, as well as the impact of depressive symptoms, remains unclear.
AIM
To investigate the correlation between HRV indicators and depressive symptoms and lung function in patients with COPD.
METHODS
A retrospective cross-sectional study involving 120 COPD patients hospitalized from January 2018 to January 2024 at our institution was conducted. Demographic and clinical characteristics were collected, and depressive symptoms were assessed using the Beck Depression Inventory (BDI). Patients were categorized into a depressed group (BDI ≥ 16) and a non-depressed group (BDI < 16). A control group consisting of 60 healthy volunteers who underwent check-ups at the same institution was also included. Statistical analyses were performed using SPSS 26.0 software. Pearson correlation coefficients were calculated to determine and compare the relationships between HRV parameters, lung function measures, and depressive symptoms across the groups.
RESULTS
Of the 120 patients with COPD, 35.8% (43/120) were diagnosed with depression, compared to 5.0% (3/60) in the control group. The HRV index in COPD patients was significantly lower than that in the control group (P < 0.05), and the value in the depressed group was significantly lower than that in the non-depressed group (P < 0.05). Similarly, the COPD group had a significantly lower pulmonary forced vital capacity (FVC), first-second expiratory volume (FEV1) and FEV1/FVC ratios than the control group (P < 0.05), and the depressed group was significantly lower than that in the non-depressed group (P < 0.05). Pearson correlation analysis revealed that the standard deviation of normal R-R intervals, standard deviation of the mean of 5-minute normal R-R intervals, root mean square of successive differences of normal R-R intervals, percentage of normal R-R intervals greater than 50 ms, high-frequency, and low-frequency indices showed positive correlations with lung function parameters (P < 0.05) and negative correlations with BDI scores (P < 0.05).
CONCLUSION
Compared to patients without COPD, the incidence of depressive symptoms is higher among patients with COPD and is negatively correlated with the patients’ HRV indices. In contrast, HRV indices are positively correlated with the patients’ pulmonary function parameters. Patients and healthcare professionals should enhance their awareness of depression, actively conduct depression assessment screenings, and incorporate HRV indices into disease management. This approach aims to improve the psychological health of patients and ultimately enhance their prognosis and quality of life.
Core Tip: Among 120 chronic obstructive pulmonary disease (COPD) patients, 35.8% (43/120) suffered from depression, compared to 5.0% (3/60) in the control group. Heart rate variability (HRV) indices, such as standard deviation of normal R-R intervals, standard deviation of the mean of 5-minute normal R-R intervals, root mean square of successive differences of normal R-R intervals, percentage of normal R-R intervals greater than 50 ms, high-frequency, and low-frequency were significantly lower in both depressed and non-depressed groups of COPD patients compared to controls (P < 0.05). Forced vital capacity (FVC), first-second expiratory volume (FEV1), and FEV1/FVC ratios were also significantly lower in both COPD patient groups compared to controls (P < 0.05). Pearson correlation analysis indicated positive correlations between HRV indices and lung function measures (P < 0.05) and negative correlations with Beck Depression Inventory scores (P < 0.05).
