Skip to main content
Top
Gepubliceerd in: Journal of Behavioral Medicine 2/2016

26-09-2015

Executive function moderates the relationship between depressive symptoms and resting heart rate variability in heart failure

Auteurs: Emily C. Gathright, Fawn A. Walter, Misty A. W. Hawkins, Mary Beth Spitznagel, Joel W. Hughes, John Gunstad

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 2/2016

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Heart failure (HF) is associated with high rates of depression. In turn, depression is associated with reduced heart rate variability (HRV), a marker of parasympathetic dysfunction and poorer cardiac outcomes. Cognitive impairment—especially executive dysfunction—is also highly prevalent in HF, but it is unknown whether executive function (EF) impacts the depression-HRV relationship. The primary objective of this paper is to examine whether EF moderates the relationship between depression and HRV in HF. Participants were 109 HF patients. Depressive symptoms were measured using the Beck Depression Inventory-II. EF was assessed using a composite of age-adjusted T scores on the Frontal Assessment Battery, Trail Making Test B, and Stroop Color Word subtest. Parasympathetic function was assessed using resting high frequency HRV (HF-HRV). Multiple hierarchical regression was used to conduct BDI × EF moderation analyses. BDI scores were associated with reduced resting HF-HRV (p < .05). No main effects were detected between EF and resting HF-HRV (p > .05). However, EF moderated the relationship between BDI scores and resting HF-HRV (β = 0.59, p < .01). Simple slope analyses revealed that among participants with poorer EF, higher BDI scores were associated with lower resting HF-HRV (p < .001). Structural brain changes common in HF may contribute to lower EF, increased depression, and poorer autonomic functioning. Alternatively, the results may indicate that individuals with intact EF engage in self-care strategies that negate the detrimental impact of depression on autonomic function. Additional work is needed to clarify these possibilities and the potential benefits of treating depression in HF patients with different cognitive abilities.
Literatuur
go back to reference Almeida, O., & Flicker, L. (2001). The mind of a failing heart: A systematic review of the association between congestive heart failure and cognitive functioning. Internal Medicine Journal, 31, 290–295.CrossRefPubMed Almeida, O., & Flicker, L. (2001). The mind of a failing heart: A systematic review of the association between congestive heart failure and cognitive functioning. Internal Medicine Journal, 31, 290–295.CrossRefPubMed
go back to reference Appollonio, I., Leone, M., Isella, V., Piamarta, F., Consoli, T., Villa, M. L., & Nichelli, P. (2005). The Frontal Assessment Battery (FAB): Normative values in an Italian population sample. Neurological Sciences, 26, 108–116.CrossRefPubMed Appollonio, I., Leone, M., Isella, V., Piamarta, F., Consoli, T., Villa, M. L., & Nichelli, P. (2005). The Frontal Assessment Battery (FAB): Normative values in an Italian population sample. Neurological Sciences, 26, 108–116.CrossRefPubMed
go back to reference Au, R., Massaro, J. M., Wolf, P. A., Young, M. E., Beiser, A., Seshadri, S., & DeCarli, C. (2006). Association of white matter hyperintensity volume with decreased cognitive functioning: The Framingham Heart Study. Archives of Neurology, 63, 246–250.CrossRefPubMed Au, R., Massaro, J. M., Wolf, P. A., Young, M. E., Beiser, A., Seshadri, S., & DeCarli, C. (2006). Association of white matter hyperintensity volume with decreased cognitive functioning: The Framingham Heart Study. Archives of Neurology, 63, 246–250.CrossRefPubMed
go back to reference Bilchick, K. C., Fetics, B., Djoukeng, R., Fisher, S. G., Fletcher, R. D., Singh, S. N., & Berger, R. D. (2002). Prognostic value of heart rate variability in chronic congestive heart failure (Veterans Affairs’ Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure). The American journal of cardiology, 90, 24–28.CrossRefPubMed Bilchick, K. C., Fetics, B., Djoukeng, R., Fisher, S. G., Fletcher, R. D., Singh, S. N., & Berger, R. D. (2002). Prognostic value of heart rate variability in chronic congestive heart failure (Veterans Affairs’ Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure). The American journal of cardiology, 90, 24–28.CrossRefPubMed
go back to reference Carney, R. M., Blumenthal, J. A., Freedland, K. E., Stein, P. K., Howells, W. B., Berkman, L. F., & Jaffe, A. (2005). Low heart rate variability and the effect of depression on post-myocardial infarction mortality. Archives of Internal Medicine, 165, 1486–1491.CrossRefPubMed Carney, R. M., Blumenthal, J. A., Freedland, K. E., Stein, P. K., Howells, W. B., Berkman, L. F., & Jaffe, A. (2005). Low heart rate variability and the effect of depression on post-myocardial infarction mortality. Archives of Internal Medicine, 165, 1486–1491.CrossRefPubMed
go back to reference Carney, R. M., Blumenthal, J. A., Stein, P. K., Watkins, L., Catellier, D., Berkman, L. F., & Freedland, K. E. (2001). Depression, heart rate variability, and acute myocardial infarction. Circulation, 104, 2024–2028.CrossRefPubMed Carney, R. M., Blumenthal, J. A., Stein, P. K., Watkins, L., Catellier, D., Berkman, L. F., & Freedland, K. E. (2001). Depression, heart rate variability, and acute myocardial infarction. Circulation, 104, 2024–2028.CrossRefPubMed
go back to reference Carney, R. M., Freedland, K. E., Miller, G. E., & Jaffe, A. S. (2002). Depression as a risk factor for cardiac mortality and morbidity: A review of potential mechanisms. Journal of Psychosomatic Research, 53, 897–902.CrossRefPubMed Carney, R. M., Freedland, K. E., Miller, G. E., & Jaffe, A. S. (2002). Depression as a risk factor for cardiac mortality and morbidity: A review of potential mechanisms. Journal of Psychosomatic Research, 53, 897–902.CrossRefPubMed
go back to reference Curtis, B. M., & O’Keefe, J. H, Jr. (2002). Autonomic tone as a cardiovascular risk factor: The dangers of chronic fight or flight. Mayo Clinic Proceedings, 77, 45–54.CrossRefPubMed Curtis, B. M., & O’Keefe, J. H, Jr. (2002). Autonomic tone as a cardiovascular risk factor: The dangers of chronic fight or flight. Mayo Clinic Proceedings, 77, 45–54.CrossRefPubMed
go back to reference Daly, M., McMinn, D., & Allan, J. L. (2015). A bidirectional relationship between physical activity and executive function in older adults. Frontiers in Human Neuroscience, 8, 104.CrossRef Daly, M., McMinn, D., & Allan, J. L. (2015). A bidirectional relationship between physical activity and executive function in older adults. Frontiers in Human Neuroscience, 8, 104.CrossRef
go back to reference Dubois, B., Slachevsky, A., Litvan, I., & Pillon, B. (2000). The FAB: A frontal assessment battery at bedside. Neurology, 55, 1621–1626.CrossRefPubMed Dubois, B., Slachevsky, A., Litvan, I., & Pillon, B. (2000). The FAB: A frontal assessment battery at bedside. Neurology, 55, 1621–1626.CrossRefPubMed
go back to reference Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefPubMed Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefPubMed
go back to reference Francis, G. S., Sonnenblick, E. H., Tang, W. H. W., & Poole-Wilson, P. (2008). Pathophysiology of heart failure. In V. Fuster, R. A. O’Rourke, R. A. Walsh, & P. Poole-Wilson (Eds.), Hurst’s the heart (12th ed., pp. 691–712). New York: McGraw Hill. Francis, G. S., Sonnenblick, E. H., Tang, W. H. W., & Poole-Wilson, P. (2008). Pathophysiology of heart failure. In V. Fuster, R. A. O’Rourke, R. A. Walsh, & P. Poole-Wilson (Eds.), Hurst’s the heart (12th ed., pp. 691–712). New York: McGraw Hill.
go back to reference Garcia, S., Spitznagel, M. B., Cohen, R., Raz, N., Sweet, L., Colbert, L., & Gunstad, J. (2011). Depression is associated with cognitive dysfunction in older adults with heart failure. Cardiovascular Psychiatry and Neurology, 2011, 368324.CrossRefPubMedPubMedCentral Garcia, S., Spitznagel, M. B., Cohen, R., Raz, N., Sweet, L., Colbert, L., & Gunstad, J. (2011). Depression is associated with cognitive dysfunction in older adults with heart failure. Cardiovascular Psychiatry and Neurology, 2011, 368324.CrossRefPubMedPubMedCentral
go back to reference Gehi, A., Mangano, D., Pipkin, S., Browner, W. S., & Whooley, M. A. (2005). Depression and heart rate variability in patients with stable coronary heart disease: Findings from the Heart and Soul Study. Archives of General Psychiatry, 62, 661–666.CrossRefPubMedPubMedCentral Gehi, A., Mangano, D., Pipkin, S., Browner, W. S., & Whooley, M. A. (2005). Depression and heart rate variability in patients with stable coronary heart disease: Findings from the Heart and Soul Study. Archives of General Psychiatry, 62, 661–666.CrossRefPubMedPubMedCentral
go back to reference Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., & Franco, S. (2014). Heart disease and stroke statistics–2014 update: A report from the American Heart Association. Circulation, 129, e28–e292.CrossRefPubMed Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., & Franco, S. (2014). Heart disease and stroke statistics–2014 update: A report from the American Heart Association. Circulation, 129, e28–e292.CrossRefPubMed
go back to reference Golden, J. C. (1978). Stroop color and word test. Chicago, IL: Stoelting Co. Golden, J. C. (1978). Stroop color and word test. Chicago, IL: Stoelting Co.
go back to reference Hansen, A. L., Johnsen, B. H., Sollers, J. J, I. I. I., Stenvik, K., & Thayer, J. F. (2004). Heart rate variability and its relation to prefrontal cognitive function: The effects of training and detraining. European Journal of Applied Physiology, 93, 262–272.CrossRef Hansen, A. L., Johnsen, B. H., Sollers, J. J, I. I. I., Stenvik, K., & Thayer, J. F. (2004). Heart rate variability and its relation to prefrontal cognitive function: The effects of training and detraining. European Journal of Applied Physiology, 93, 262–272.CrossRef
go back to reference Hansen, A. L., Johnsen, B. H., & Thayer, J. F. (2003). Vagal influence on working memory and attention. International Journal of Psychophysiology, 48, 263–274.CrossRefPubMed Hansen, A. L., Johnsen, B. H., & Thayer, J. F. (2003). Vagal influence on working memory and attention. International Journal of Psychophysiology, 48, 263–274.CrossRefPubMed
go back to reference Hansen, A. L., Johnsen, B. H., & Thayer, J. F. (2009). Relationship between heart rate variability and cognitive function during threat of shock. Anxiety, Stress, & Coping, 22, 77–89.CrossRef Hansen, A. L., Johnsen, B. H., & Thayer, J. F. (2009). Relationship between heart rate variability and cognitive function during threat of shock. Anxiety, Stress, & Coping, 22, 77–89.CrossRef
go back to reference Herrmann, L. L., Le Masurier, M., & Ebmeier, K. P. (2008). White matter hyperintensities in late life depression: A systematic review. Journal of Neurolgy, Neurosurgery & Psychiatry, 79, 619–624.CrossRef Herrmann, L. L., Le Masurier, M., & Ebmeier, K. P. (2008). White matter hyperintensities in late life depression: A systematic review. Journal of Neurolgy, Neurosurgery & Psychiatry, 79, 619–624.CrossRef
go back to reference Huikuri, H. V., Jokinen, V., Syvänne, M., Nieminen, M. S., Airaksinen, K. J., Ikäheimo, M. J., & Frick, M. H. (1999). Heart rate variability and progression of coronary atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology, 19, 1979–1985.CrossRefPubMed Huikuri, H. V., Jokinen, V., Syvänne, M., Nieminen, M. S., Airaksinen, K. J., Ikäheimo, M. J., & Frick, M. H. (1999). Heart rate variability and progression of coronary atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology, 19, 1979–1985.CrossRefPubMed
go back to reference Insel, K., Morrow, D., Brewer, B., & Figueredo, A. (2006). Executive function, working memory, and medication adherence among older adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61, 102–107.CrossRef Insel, K., Morrow, D., Brewer, B., & Figueredo, A. (2006). Executive function, working memory, and medication adherence among older adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61, 102–107.CrossRef
go back to reference Jensen, A. R., & Rohwer, W. D. (1966). The Stroop color-word test: A review. Acta Psychologica, 25, 36–93.CrossRefPubMed Jensen, A. R., & Rohwer, W. D. (1966). The Stroop color-word test: A review. Acta Psychologica, 25, 36–93.CrossRefPubMed
go back to reference Jones, C. J., & Rikli, R. E. (2002). Measuring functional fitness of older adults. Journal on Active Aging, 1, 24–30. Jones, C. J., & Rikli, R. E. (2002). Measuring functional fitness of older adults. Journal on Active Aging1, 24–30.
go back to reference Kemp, A. H., Quintana, D. S., Gray, M. A., Felmingham, K. L., Brown, K., & Gatt, J. M. (2010). Impact of depression and antidepressant treatment on heart rate variability: A review and meta-analysis. Biological Psychiatry, 67, 1067–1074.CrossRefPubMed Kemp, A. H., Quintana, D. S., Gray, M. A., Felmingham, K. L., Brown, K., & Gatt, J. M. (2010). Impact of depression and antidepressant treatment on heart rate variability: A review and meta-analysis. Biological Psychiatry, 67, 1067–1074.CrossRefPubMed
go back to reference Manfrini, O., Pizzi, C., Trerè, D., Fontana, F., & Bugiardini, R. (2003). Parasympathetic failure and risk of subsequent coronary events in unstable angina and non-ST-segment elevation myocardial infarction. European Heart Journal, 24, 1560–1566.CrossRefPubMed Manfrini, O., Pizzi, C., Trerè, D., Fontana, F., & Bugiardini, R. (2003). Parasympathetic failure and risk of subsequent coronary events in unstable angina and non-ST-segment elevation myocardial infarction. European Heart Journal, 24, 1560–1566.CrossRefPubMed
go back to reference Manfrini, O., Pizzi, C., Viecca, M., & Bugiardini, R. (2008). Abnormalities of cardiac autonomic nervous activity correlate with expansive coronary artery remodeling. Atherosclerosis, 197, 183–189.CrossRefPubMed Manfrini, O., Pizzi, C., Viecca, M., & Bugiardini, R. (2008). Abnormalities of cardiac autonomic nervous activity correlate with expansive coronary artery remodeling. Atherosclerosis, 197, 183–189.CrossRefPubMed
go back to reference Navarro, V., Gastó, C., Lomeña, F., Mateos, J. J., Marcos, T., & Portella, M. J. (2002). Normalization of frontal cerebral perfusion in remitted elderly major depression: A 12- month follow-up SPECT study. Neuroimage, 16, 781–787.CrossRefPubMed Navarro, V., Gastó, C., Lomeña, F., Mateos, J. J., Marcos, T., & Portella, M. J. (2002). Normalization of frontal cerebral perfusion in remitted elderly major depression: A 12- month follow-up SPECT study. Neuroimage, 16, 781–787.CrossRefPubMed
go back to reference Pihl, E., Jacobsson, A., Fridlund, B., Strömberg, A., & Måtensson, J. (2005). Depression and health-related quality of life in elderly patients suffering from heart failure and their spouses: A comparative study. European Journal of Heart Failure, 7, 583–589.CrossRefPubMed Pihl, E., Jacobsson, A., Fridlund, B., Strömberg, A., & Måtensson, J. (2005). Depression and health-related quality of life in elderly patients suffering from heart failure and their spouses: A comparative study. European Journal of Heart Failure, 7, 583–589.CrossRefPubMed
go back to reference Pressler, S. J., Kim, J., Riley, P., Ronis, D. L., & Gradus-Pizlo, I. (2010). Memory dysfunction, psychomotor slowing, and decreased executive function predict mortality in patients with heart failure and low ejection fraction. Journal of Cardiac Failure, 16, 750–760.CrossRefPubMedPubMedCentral Pressler, S. J., Kim, J., Riley, P., Ronis, D. L., & Gradus-Pizlo, I. (2010). Memory dysfunction, psychomotor slowing, and decreased executive function predict mortality in patients with heart failure and low ejection fraction. Journal of Cardiac Failure, 16, 750–760.CrossRefPubMedPubMedCentral
go back to reference Rabinowitz, A. R., & Arnett, P. A. (2009). A longitudinal analysis of cognitive dysfunction, coping, and depression in multiple sclerosis. Neuropsychology, 23, 581.CrossRefPubMed Rabinowitz, A. R., & Arnett, P. A. (2009). A longitudinal analysis of cognitive dysfunction, coping, and depression in multiple sclerosis. Neuropsychology, 23, 581.CrossRefPubMed
go back to reference Reitan, R. M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271–276.CrossRef Reitan, R. M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271–276.CrossRef
go back to reference Rutledge, T., Reis, V. A., Linke, S. E., Greenberg, B. H., & Mills, P. J. (2006). Depression in heart failure: A meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. Journal of the American College of Cardiology, 48, 1527–1537.CrossRefPubMed Rutledge, T., Reis, V. A., Linke, S. E., Greenberg, B. H., & Mills, P. J. (2006). Depression in heart failure: A meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. Journal of the American College of Cardiology, 48, 1527–1537.CrossRefPubMed
go back to reference Sherwood, A., Allen, M. T., Fahrenberg, J., Kelsey, R. M., Lovallo, W. R., & Doornen, L. J. (1990). Methodological guidelines for impedance cardiography. Psychophysiology, 27(1), 1–23.CrossRefPubMed Sherwood, A., Allen, M. T., Fahrenberg, J., Kelsey, R. M., Lovallo, W. R., & Doornen, L. J. (1990). Methodological guidelines for impedance cardiography. Psychophysiology27(1), 1–23.CrossRefPubMed
go back to reference Sloan, R. P., Shapiro, P. A., Bagiella, E., Myers, M. M., & Gorman, J. M. (1999). Cardiac autonomic control buffers blood pressure variability responses to challenge: A psychophysiologic model of coronary artery disease. Psychosomatic Medicine, 61, 58–68.CrossRefPubMed Sloan, R. P., Shapiro, P. A., Bagiella, E., Myers, M. M., & Gorman, J. M. (1999). Cardiac autonomic control buffers blood pressure variability responses to challenge: A psychophysiologic model of coronary artery disease. Psychosomatic Medicine, 61, 58–68.CrossRefPubMed
go back to reference Snyder, H. R. (2013). Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: A meta-analysis and review. Psychological Bulletin, 139, 81–132.CrossRefPubMedPubMedCentral Snyder, H. R. (2013). Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: A meta-analysis and review. Psychological Bulletin, 139, 81–132.CrossRefPubMedPubMedCentral
go back to reference Spitznagel, M. B., Potter, V., Miller, L. A., Miller, A. N. R., Hughes, J., Rosneck, J., & Gunstad, J. (2013). Ability to regulate emotion is predicted by depressive symptoms and cognitive function in a cardiac sample. Journal of Cardiovascular Nursing, 28, 453–459.CrossRefPubMed Spitznagel, M. B., Potter, V., Miller, L. A., Miller, A. N. R., Hughes, J., Rosneck, J., & Gunstad, J. (2013). Ability to regulate emotion is predicted by depressive symptoms and cognitive function in a cardiac sample. Journal of Cardiovascular Nursing, 28, 453–459.CrossRefPubMed
go back to reference Vogels, R. L., Flier, W. M., Harten, B., Gouw, A. A., Scheltens, P., Schroeder-Tanka, J. M., & Weinstein, H. C. (2007a). Brain magnetic resonance imaging abnormalities in patients with heart failure. European Journal of Heart Failure, 9, 1003–1009.CrossRefPubMed Vogels, R. L., Flier, W. M., Harten, B., Gouw, A. A., Scheltens, P., Schroeder-Tanka, J. M., & Weinstein, H. C. (2007a). Brain magnetic resonance imaging abnormalities in patients with heart failure. European Journal of Heart Failure, 9, 1003–1009.CrossRefPubMed
go back to reference Vogels, R. L., Oosterman, J. M., Laman, D. M., Gouw, A. A., Schroeder-Tanka, J. M., Scheltens, P., & Weinstein, H. C. (2008). Transcranial Doppler blood flow assessment in patients with mild heart failure: Correlates with neuroimaging and cognitive performance. Congestive Heart Failure, 14, 61–65.CrossRefPubMed Vogels, R. L., Oosterman, J. M., Laman, D. M., Gouw, A. A., Schroeder-Tanka, J. M., Scheltens, P., & Weinstein, H. C. (2008). Transcranial Doppler blood flow assessment in patients with mild heart failure: Correlates with neuroimaging and cognitive performance. Congestive Heart Failure, 14, 61–65.CrossRefPubMed
go back to reference Vogels, R. L., Oosterman, J. M., Van Harten, B., Scheltens, P., Van Der Flier, W. M., Schroeder-Tanka, J. M., & Weinstein, H. C. (2007b). Profile of cognitive impairment in chronic heart failure. Journal of the American Geriatrics Society, 55, 1764–1770.CrossRefPubMed Vogels, R. L., Oosterman, J. M., Van Harten, B., Scheltens, P., Van Der Flier, W. M., Schroeder-Tanka, J. M., & Weinstein, H. C. (2007b). Profile of cognitive impairment in chronic heart failure. Journal of the American Geriatrics Society, 55, 1764–1770.CrossRefPubMed
go back to reference Wang, Y.-P., & Gorenstein, C. (2013). Psychometric properties of the Beck Depression Inventory-II: A comprehensive review. Revista Brasileira de Psiquiatria, 35, 416–431.CrossRefPubMed Wang, Y.-P., & Gorenstein, C. (2013). Psychometric properties of the Beck Depression Inventory-II: A comprehensive review. Revista Brasileira de Psiquiatria, 35, 416–431.CrossRefPubMed
go back to reference Xhyheri, B., Manfrini, O., Mazzolini, M., Pizzi, C., & Bugiardini, R. (2012). Heart rate variability today. Progress in Cardiovascular Diseases, 55, 321–331.CrossRefPubMed Xhyheri, B., Manfrini, O., Mazzolini, M., Pizzi, C., & Bugiardini, R. (2012). Heart rate variability today. Progress in Cardiovascular Diseases, 55, 321–331.CrossRefPubMed
go back to reference Zuccalà, G., Onder, G., Marzetti, E., Lo Monaco, M. R., Cesari, M., Cocchi, A., & Bernabei, R. (2005). Use of angiotensin-converting enzyme inhibitors and variations in cognitive performance among patients with heart failure. European Heart Journal, 26, 226–233.CrossRefPubMed Zuccalà, G., Onder, G., Marzetti, E., Lo Monaco, M. R., Cesari, M., Cocchi, A., & Bernabei, R. (2005). Use of angiotensin-converting enzyme inhibitors and variations in cognitive performance among patients with heart failure. European Heart Journal, 26, 226–233.CrossRefPubMed
Metagegevens
Titel
Executive function moderates the relationship between depressive symptoms and resting heart rate variability in heart failure
Auteurs
Emily C. Gathright
Fawn A. Walter
Misty A. W. Hawkins
Mary Beth Spitznagel
Joel W. Hughes
John Gunstad
Publicatiedatum
26-09-2015
Uitgeverij
Springer US
Gepubliceerd in
Journal of Behavioral Medicine / Uitgave 2/2016
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI
https://doi.org/10.1007/s10865-015-9684-8

Andere artikelen Uitgave 2/2016

Journal of Behavioral Medicine 2/2016 Naar de uitgave

Letter to the Editor

Authors’ response