Difficulties on Emotion Regulation Predict Mental Health of Coronary Heart Disease Patients in Cardiac Rehabilitation but Heart Rate Variability does Not

Purpose: Depression and anxiety have been extensively associated with adverse outcomes in coronary heart disease (CHD) patients. However, psychological and physiological processes underlying the persistence of these troubles in CHD patients attending cardiac rehabilitation are poorly investigated. Emotion regulation difficulties and heart rate variability (HRV) could be some of these processes. Thus the aim of this study was to assess the predictive value of emotion regulation difficulties and HRV on depression and anxiety symptoms persistence in CHD patients.

Methods: Eigthy-four patients who recently presented a myocardial infarction were evaluated at the beginning of cardiac rehabilitation. Fourty-two patients continued their rehabilitation program and were then assessed three months later. They completed the Difficulties in Emotion Regulation Scale (DERS), the Hospital Anxiety and Depression scale (HADS) and underwent a five minutes resting HRV measure.

Results: Emotion regulation difficulties predicted depression and anxiety persistence at 3-month follow-up even after controlling for depression or anxiety scores at baseline. Contrary to our expectations, HRV did not predict depression or anxiety symptoms persistence and was not associated with emotion regulation difficulties.

Conclusion: This study highlights the predictive value of emotion regulation difficulties on the persistence of depression and anxiety symptoms at the end of cardiac rehabilitation of CHD patients. However, HRV was not associated with either depression or anxiety supporting the idea of mixed litterature and calling for future research.

Keywords:Heart rate variability; Emotion regulation; Depression; Anxiety; Coronary heart disease

Abbreviations:HRV: Heart rate variability; CHD: Coronary heart disease