Giulio Toni1, Martino Belvederi Murri2, Massimo Piepoli3, Stamatula Zanetidou4, Aderville Cabassi5, Salvatore Squatrito6, Luigi Bagnoli7, Alessandro Piras6, Chiara Mussi8, Roberto Senaldi9, Marco Menchetti10, Donato Zocchi7, Giuliano Ermini7, Graziano Ceresini11, Ferdinando Tripi12, Paola Rucci6, George S Alexopoulos13, Mario Amore14. 1. Cardiology Unit, Ramazzini Hospital, Carpi, Italy. 2. Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy; Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK. Electronic address: martino.belvederi@gmail.com. 3. Heart Failure Unit, Cardiac Department, G. da Saliceto Polichirurgico Hospital, Piacenza, Italy. 4. Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy. 5. Cardiorenal Research Unit, Department of Clinical and Experimental Medicine, Parma University School of Medicine, Parma, Italy. 6. Department of Biomedical and Neuromotor Sciences, Section of Human and General Physiology, University of Bologna, Italy. 7. Primary Care Physicians in Private Practice, Bologna, Italy. 8. Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena, and Reggio Emilia University, Modena, Italy. 9. Sport Medicine Institute, University of Bologna, Italy. 10. Department of Medical and Surgical Sciences, University of Bologna, Italy. 11. Department of Clinical and Experimental Medicine, Endocrinology of Aging Unit, University of Parma, Italy. 12. Sports medicine Unit, Regional Hospital of Modena, Italy. 13. Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA. 14. Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy.
Abstract
OBJECTIVES: Late-life major depression is associated with increased cardiovascular risk and impaired autonomic control of the heart, as evident from reduced heart rate variability (HRV). Moreover, antidepressant drug therapy also might be associated with further reductions of HRV. In the SEEDS study, we investigated whether sertraline associated with physical exercise protocols led to improvements of HRV, compared with antidepressant drug therapy alone. DESIGN: Single-blind randomized controlled trial. SETTING:Psychiatric consultation-liaison program for primary care. PARTICIPANTS: Patients aged 65-85 years with major depression, recruited from primary care. INTERVENTIONS:Sertraline plus structured, tailored group physical exercise (S + EX) versus sertraline alone (S) for 24 weeks. MEASUREMENTS: HRV indices (RR, percentage of NN intervals greater than 50 msec [pNN50], square root of the mean squared differences of successive NN intervals [RMSSD], standard deviation of heart rate [SDHR], standard deviation of the NN interval [SDNN], high-frequency band [HF], low-frequency band [LF], and their ratio [LF/HF]) were measured at baseline, week 12, and week 24. Psychiatric and medical assessments. RESULTS: Participants displayed significant improvements of most HRV indices over time, irrespective of the group assignment (pNN50, RMSSD, SDHR, SDNN, HF, LF, and LF/HF). Moreover, patients in the S + EX group displayed greater increases of different HRV indices(RR, pNN50, RMSSD, SDHR, SDNN, HF, and LF) compared with those in the S group. CONCLUSIONS: The combination of structured physical exercise and sertraline might exert positive effects on the autonomic control of the heart among older patients with major depression.
RCT Entities:
OBJECTIVES: Late-life major depression is associated with increased cardiovascular risk and impaired autonomic control of the heart, as evident from reduced heart rate variability (HRV). Moreover, antidepressant drug therapy also might be associated with further reductions of HRV. In the SEEDS study, we investigated whether sertraline associated with physical exercise protocols led to improvements of HRV, compared with antidepressant drug therapy alone. DESIGN: Single-blind randomized controlled trial. SETTING:Psychiatric consultation-liaison program for primary care. PARTICIPANTS: Patients aged 65-85 years with major depression, recruited from primary care. INTERVENTIONS:Sertraline plus structured, tailored group physical exercise (S + EX) versus sertraline alone (S) for 24 weeks. MEASUREMENTS: HRV indices (RR, percentage of NN intervals greater than 50 msec [pNN50], square root of the mean squared differences of successive NN intervals [RMSSD], standard deviation of heart rate [SDHR], standard deviation of the NN interval [SDNN], high-frequency band [HF], low-frequency band [LF], and their ratio [LF/HF]) were measured at baseline, week 12, and week 24. Psychiatric and medical assessments. RESULTS:Participants displayed significant improvements of most HRV indices over time, irrespective of the group assignment (pNN50, RMSSD, SDHR, SDNN, HF, LF, and LF/HF). Moreover, patients in the S + EX group displayed greater increases of different HRV indices(RR, pNN50, RMSSD, SDHR, SDNN, HF, and LF) compared with those in the S group. CONCLUSIONS: The combination of structured physical exercise and sertraline might exert positive effects on the autonomic control of the heart among older patients with major depression.
Authors: Hossam A Shaltout; Sung W Lee; Catherine L Tegeler; Joshua R Hirsch; Sean L Simpson; Lee Gerdes; Charles H Tegeler Journal: Front Public Health Date: 2018-04-25
Authors: Alessandro Piras; Lorenzo Zini; Aurelio Trofè; Francesco Campa; Milena Raffi Journal: Int J Environ Res Public Health Date: 2021-04-26 Impact factor: 3.390