The authors analyzed the manifestations of anxiety and depressive disorders, disturbance of autonomic regulation and changes in the level of catecholamines in the blood of patients with acute coronary syndrome from the perspective of outcomes of the disease. 102 men with a diagnosis of acute coronary syndrome were examined. Blood samples for the determination of catecholamines (epinephrine, norepinephrine, dopamine) was performed at admission, psychological examination and scrutiny of heart rate variability was performed on the third-fourth day of the hospitalization. All patients were divided into three groups. The first group was executed on 14 (13,7%) patients who had fatal myocardial infarction developed during hospitalization. In the second group there were 40 (47,1%) patients with non-fatal myocardial infarction. The third group included 48 (47,1%) patients with unstable angina. It was shown, that levels of anxiety and depression were inverse correlated with the concentration of dopamine in the plasma, and adrenaline levels are positively correlated with indicators of overall heart rate variability and its high frequency component. Thus, in patients with acute coronary syndrome, who developed myocardial infarction the incidence and severity of anxiety and depressive disorders is substantially lower than in patients with unstable angina. Increase in high frequency component of heart rate variability was more typical for patients with acute coronary syndrome who developed fatal myocardial infarction during hospitalization. High levels of dopamine in the blood plasma are typical for patients with nonfatal myocardial infarction.
anxiety and depressive disorders, autonomic regulation, blood catecholamine levels, acute coronary syndrome
1. Abseitova S.R. Chastota i struktura psikhopatologicheskikh rasstroystv u bol´nykh s razlichnymi klinicheskimi formami ishemicheskoy bolezni serdtsa. Yuzhno-Kazakhstanskaya gosudarstvennaya meditsinskaya akademiya, Oblastnoy kardiologicheskiy tsentr, 2008. 7 s.
2. Boldueva S.A., Trofimova O.V., Gimgina A.A. Vzaimosvyaz´ narusheniy psikhiki s sostoyaniem vegetativnoy regulyatsii serdechnogo ritma i vnezapnoy smert´yu bol´nykh, perenesshikh infarkt miokarda. Rossiyskiy kardiologicheskiy zhurnal. 2008. № 1(69). S. 26-31.
3. Vasyuk Yu.A., Lebedev A.V. Depressiya, trevoga i infarkt miokarda: vse tol´ko nachinaetsya. Chast´ 1. Ratsional´naya farmakoterapiya v kardiologii. 2007. T.3. №3. S. 41-51.
4. Psikhicheskie rasstroystva v terapevticheskoy praktike. Rekomendatsii po diagnostike i lecheniyu. Pod redaktsiey F. I. Belyalova. Irkutsk, 2011. 37 s.
5. Yavelov I.S., Travina E.E., Gratsianskiy N.A. Izmerenie variabel´nosti ritma serdtsa, otsenennoy za korotkoe vremya v standartnykh usloviyakh u bol´nykh, pere-nesshikh infarkt miokarda. Kardiologiya. 1999. №5. S. 4-11.
6. Heart Rate Variability: Standards of Measurement, Physiological Interpretation, and Clinical Use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. European Heart Journal. 1996. V. 17. P. 354-381.
7. Morozov V.N., Khadartsev A.A. K sovremennoy trak-tovke mekhanizmov stressa. Vestnik novykh meditsinskikh-tekhnologiy. 2010. № 1. C. 15-17.
