The aim was to clarify the developmental nature of associations between psychiatric illness and risk for cardiovascular disease by investigating differences in cardiac functioning between youth with anxiety disorders and healthy controls. Twenty-two children meeting DSM-IV criteria for either separation anxiety disorder, overanxious disorder, panic disorder/panic attacks, or social phobia and 12 healthy controls underwent continuous electrocardiogram and respiration rate monitoring during a 15 min baseline period and 15 min of exposure to 5% CO(2). Heart rate (HR) and high frequency heart rate variability (HRV), a non-invasive measure of cardiac parasympathetic control, were calculated. Youth with anxiety disorders had higher and less fluctuating HR during baseline. Data also suggested that probands showed diminished overall changes in HRV during baseline and CO(2) inhalation relative to controls. However, as respiration rate affects HRV, these findings were confounded by changes in respiration elicited by CO(2) inhalation. The data suggest that youth with anxiety disorders experience an elevated and less fluctuating HR in the face of a novel situation, possibly due to a failure to appropriately modulate HRV. In adults, sustained elevations in HR in conjunction with deficient vagal modulation predicts risk for future cardiovascular disease. As such, the current data suggest that the presence of an anxiety disorder may identify youth who exhibit autonomic profiles that place them at risk for cardiac disease.

译文

目的是通过调查焦虑症青年与健康对照者之间心脏功能的差异,阐明精神疾病与心血管疾病风险之间关联的发展性质。22名符合dsm-iv标准的分离焦虑症,过度焦虑症,恐慌症/惊恐发作或社交恐惧症的儿童和12名健康对照者在15分钟的基线期和15分钟的暴露期间接受了连续心电图和呼吸频率监测5% CO(2)。计算了心率 (HR) 和高频心率变异性 (HRV),这是一种非侵入性的心脏副交感神经控制措施。焦虑症的青年在基线期间的HR波动较高,且波动较小。数据还表明,先证者显示,相对于对照组,基线和CO(2) 吸入期间HRV的总体变化减少。然而,由于呼吸速率会影响HRV,因此这些发现被CO(2) 吸入引起的呼吸变化所混淆。数据表明,面对新情况,患有焦虑症的年轻人的HR升高且波动较小,这可能是由于未能适当调节HRV所致。在成人中,HR的持续升高与迷走神经调节不足相结合可预测未来心血管疾病的风险。因此,当前的数据表明焦虑症的存在可能会识别出表现出自主神经特征的年轻人,这使他们有患心脏病的风险。

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