# The Association of Autonomic Dysfunction with the Relationship between Depression and Coronary Disease

> **NIH NIH F32** · UNIVERSITY OF ILLINOIS AT CHICAGO · 2023 · $92,052

## Abstract

A3. PROJECT ABSTRACT
Comorbid depression and coronary artery disease (CAD) lead to a three-fold increase in cardiovascular
mortality, but the mechanisms behind this pathology remain poorly understood. This is major public health
issue as depression remains a leading cause of disability globally and CAD is the leading cause of death. Up
to 1 of every 5 patients with CAD have comorbid depression, yet interventions from increased screening for
depression and treatment through traditional methods have not shown any impact on overall outcomes. A
potential mechanistic pathway for depression and CAD is dysfunction of the autonomic nervous system (ANS).
Vagal nerve stimulation, for example, improves refractory depression and reduces chest pain from ischemic
heart disease, suggesting that strong shared biological relationships exist. Heart rate variability (HRV) serves
as an electrocardiographic biomarker of autonomic function, by measuring the sympathetic and
parasympathetic outflow to the sinoatrial node of the heart. Low HRV represents autonomic dysfunction. We
have shown that that a novel HRV measure, Dyx, shows promise as a predictor of abnormal myocardial
perfusion, and in preliminary analysis shows a relationship with depression. We seek to explore the potential of
HRV to serve as a means of investigating dysfunction of both central processes such as depression and
peripheral cardiovascular reflexes as they relate to obstructive CAD. We hypothesize that low HRV will be
associated with both depression and coronary artery disease in a dose-response manner, and that this
relationship will be modified by age and sex. In the pilot study on this cohort, preliminary data that these
associations exist. To fully characterize this association between depression, CAD, and ANS dysfunction, we
will examine the changes in HRV in a cohort of 200 participants with both depression and CAD, either disease,
or neither. Aim 1 will compare the depressive symptom burden with ANS dysfunction as measured by Dyx
amongst other HRV measures. Aim 2 will compare the presence of obstructive CAD with ANS dysfunction as
measured by Dyx. The interaction of age, sex, and time of day of HRV measurement with the findings will be
considered. The proposed analyses will provide plausible evidence that the ANS dysfunction links both
depression and CAD, with the long-term goal of identifying interventions that target ANS dysfunction to reduce
mortality.

## Key facts

- **NIH application ID:** 10524731
- **Project number:** 5F32HL154707-03
- **Recipient organization:** UNIVERSITY OF ILLINOIS AT CHICAGO
- **Principal Investigator:** Anish Sanjay Shah
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $92,052
- **Award type:** 5
- **Project period:** 2021-12-01 → 2023-12-02

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10524731

## Citation

> US National Institutes of Health, RePORTER application 10524731, The Association of Autonomic Dysfunction with the Relationship between Depression and Coronary Disease (5F32HL154707-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10524731. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*