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Symptoms of anxiety and mood disturbance alter cardiac and peripheral autonomic control in patients with metabolic syndrome

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Abstract

Previous investigations show that metabolic syndrome (MetSyn) causes sympathetic hyperactivation. Symptoms of anxiety and mood disturbance (AMd) provoke sympatho-vagal imbalance. We hypothesized that AMd would alter even further the autonomic function in patients with MetSyn. Twenty-six never-treated patients with MetSyn (ATP-III) were allocated to two groups, according to the levels of anxiety and mood disturbance: (1) with AMd (MetSyn + AMd, n = 15), and (2) without AMd (MetSyn, n = 11). Ten healthy control subjects were also studied (C, n = 10). AMd was determined using quantitative questionnaires. Muscle sympathetic nerve activity (MSNA, microneurography), blood pressure (oscillometric beat-to-beat basis), and heart rate (ECG) were measured during a baseline 10-min period. Spectral analysis of RR interval and systolic arterial pressure were analyzed, and the power of low (LF) and high (HF) frequency bands were determined. Sympatho-vagal balance was obtained by LF/HF ratio. Spontaneous baroreflex sensitivity (BRS) was evaluated by calculation of α-index. MSNA was greater in patients with MetSyn + AMd compared with MetSyn and C. Patients with MetSyn + AMd showed higher LF and lower HF power compared with MetSyn and C. In addition, LF/HF balance was higher in MetSyn + AMd than in MetSyn and C groups. BRS was decreased in MetSyn + AMd compared with MetSyn and C groups. Anxiety and mood disturbance alter autonomic function in patients with MetSyn. This autonomic dysfunction may contribute to the increased cardiovascular risk observed in patients with mood alterations.

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Abbreviations

AMd:

Anxiety and mood disturbance

BMI:

Body mass index

BP:

Blood pressure

BRS:

Baroreflex sensitivity

HF:

High frequency

k 2 :

Coherence

LF:

Low frequency

LF/HF:

Sympatho-vagal balance

MetSyn:

Metabolic syndrome

MSN:

Muscle sympathetic nerve activity

n.u.:

Normalized unit

pNN50:

Percent of successive RR interval differences >50 ms

POM:

Profile of mood states

rMSSD:

Root mean squares successive differences of RR intervals

RRI:

RR interval

SAP:

Systolic arterial pressure

SDNN:

Standard deviation of RR intervals

STAI:

State and trait anxiety inventory

TMD:

Total mood disturbance

VLF:

Very low frequency

φ:

Phase shift

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Acknowledgments

This study was supported by Conselho Nacional de Pesquisa (CNPq # 476385/2006-7), by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP # 2010/50048-1) and, in part, by Fundação Zerbini. Toschi-Dias E, Negrão CE and Rondon MUPB were supported by Conselho Nacional de Pesquisa (CNPq # 140643/2009-5, # 301867/2010-0, # 308068/2011-4, respectively). Trombetta IC was supported by Fundação de Amparo à Pesquisa (FAPESP # 2008/03714-6). Maki-Nunes C and Martinez DG were supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).

Conflict of interest

The authors declared no conflict of interest.

Author information

Authors and Affiliations

  1. Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil

    Edgar Toschi-Dias, Ivani C. Trombetta, Cristiane Maki-Nunes, Maria Janieire N. N. Alves, Luciana F. Angelo, Felipe X. Cepeda, Daniel G. Martinez, Carlos Eduardo Negrão & Maria Urbana P. B. Rondon

  2. School of Medicine, Federal University of the Triângulo Mineiro, Minas Gerais, Brazil

    Valdo José Dias da Silva

  3. School of Physical Education and Sport, University of São Paulo, Av. Prof. Mello de Moraes, 65 Butantã, São Paulo, 05508-030, Brazil

    Carlos Eduardo Negrão & Maria Urbana P. B. Rondon

Authors
  1. Edgar Toschi-Dias
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  2. Ivani C. Trombetta
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  3. Valdo José Dias da Silva
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  4. Cristiane Maki-Nunes
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  5. Maria Janieire N. N. Alves
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  6. Luciana F. Angelo
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  7. Felipe X. Cepeda
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  8. Daniel G. Martinez
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  9. Carlos Eduardo Negrão
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  10. Maria Urbana P. B. Rondon
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Corresponding author

Correspondence to Maria Urbana P. B. Rondon.

Additional information

Communicated by Dag Linnarsson.

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Toschi-Dias, E., Trombetta, I.C., da Silva, V.J.D. et al. Symptoms of anxiety and mood disturbance alter cardiac and peripheral autonomic control in patients with metabolic syndrome. Eur J Appl Physiol 113, 671–679 (2013). https://doi.org/10.1007/s00421-012-2476-8

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  • DOI: https://doi.org/10.1007/s00421-012-2476-8

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