Improving effect of paroxetine on heart function and its influence on sympathetic nerve-GRK2 pathway in patients with acute myocardial infarction accompanied by depression
Guo Gaiping
Zhu Xiaofang
Liu Yanming
Peng Xuhui
Abstract：Objective To study the improving effect of paroxetine on heart function and its negative regulative mechanism to sympathetic nerve-G protein-coupled receptor kinase 2 (GRK2) in patients with acute myocardial infarction (AMI) accompanied by depression. Methods AMI patients (n=272) were chosen from Department of Cardiology of the Second People’s Hospital of Pingdingshan City from July 2016 to May 2018. All patients were scored according to hospital anxiety and depression scale (HADS) and Hamilton Depression Scale (HAMD-17), and among them there were 84 patients with AMI accompanied by depression, who were divided randomly into paroxetine treatment group (n=35, AMID-P group), fluoxetine treatment group (n=29, AMID-F group) and non-antidepression treatment group (n=20, AMID-N group). All patients were treated for 12 weeks. The patients (n=188) with AMI but without depression were chosen into control group. The indexes of left ventricular ejection fraction (LVEF), left ventricular end-diastolic inner diameter (LVEDd), left ventricular fraction shortening (LVFS) and indexes of heart rate variability (HRV) including high frequency (HF, 0.15 Hz -0.40 Hz), low frequency (LF, 0.04 Hz-0.15 Hz), standard deviation of all normal RR interval (SDNN), and levels of peripheral blood GRK2, noradrenalin (NE) and epinephrine (EPI) were detected in all groups before and after treatment. The relationship among all indexes was analyzed by using Spearman correlation analysis. Results The level of peripheral blood GRK2 was significantly higher in patients with AMI accompanied by depression than that in those with only AMI (P<0.05). After treatment for 12 weeks, the level of GRK2 and indexes of LVEF, LVEDd, LVFS, HF, LF and SDNN were all improved significantly in AMID-P group, and were superior to those in AMID-N group and AMID-F group (P<0.05). The scores of HAMD-17 and scores of HADS decreased significantly in AMID-P group and AMID-F group (P<0.05), and there was no statistical difference between these 2 groups (P>0.05) after treatment. The results of Spearman correlation analysis showed that level of GRK2 was negatively correlated to SDNN and LF (P<0.05) and positively correlated to NE, EPI, HAMD-17 scores and HADS scores (P<0.05) in AMID-P group. Conclusion Paroxetine can improve heart function possibly through inhibiting directly or indirectly excitability of sympathetic nervous system induced by GRK2 in patients with AMI accompanied by depression.
Keywords：ParoxetineG protein-coupled receptor kinase 2Sympathetic nerveAcute myocardial infarctionDepression
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 418-422 )