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Yang X, Wang X, Li Z, Yi B, Liang C, Liu X, Li Y, He W. The change of state-trait anxiety among patients undergoing orthognathic surgery: A longitudinal study. Am J Orthod Dentofacial Orthop 2024; 165:628-637. [PMID: 38466249 DOI: 10.1016/j.ajodo.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 03/12/2024]
Abstract
INTRODUCTION This study aimed to assess state-trait anxiety level changes in Chinese patients with dentofacial discrepancies before and after orthognathic surgery and to explore the feasibility of developing a reference index for the preoperative screening of postoperative patients with high anxiety. METHODS A total of 96 Chinese patients with dentofacial discrepancies who underwent orthognathic surgery were included in this study. Data were collected before orthognathic surgery and at 2 weeks (T2), 3 months, and 6 months (T4) after surgery using the State-Trait Anxiety Inventory. Receiver operating characteristic and linear regression analyses were performed to screen for preoperative indicators of postoperative high-state anxiety. RESULTS State-trait anxiety levels in patients with dentofacial discrepancies decreased after surgery (F = 18.95, P <0.01; F = 6.90, P <0.01). Trait Anxiety Inventory can be used to screen patients with high-state anxiety from T2 to T4 (area under cover 95% confidence interval: T2, 0.74 [0.62-0.86]; 3 months, 0.79 [0.69-0.90]; T4, 0.77 [0.66-0.87], P <0.01), corresponding to cutoff values of 48.5, 46.5, and 45.5, respectively. CONCLUSIONS All participants' state-trait anxiety levels improved after surgery compared with their preoperative levels. Preoperative trait anxiety levels can be used as a reference indicator to screen patients who may have high-state anxiety levels after orthognathic surgery. The creation of a screening scale will assist health care professionals to more pertinently help patients with high anxiety.
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Affiliation(s)
- Xin Yang
- Department of Oral and Maxillofacial Surgery, The affiliated Yantai Stomatological Hospital, Binzhou Medical University, Yantai, Shandong, China
| | - Xiaoxia Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.
| | - Zili Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Biao Yi
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Cheng Liang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiaojing Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yang Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wei He
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Tasci B, Tasci G, Dogan S, Tuncer T. A novel ternary pattern-based automatic psychiatric disorders classification using ECG signals. Cogn Neurodyn 2024; 18:95-108. [PMID: 38406197 PMCID: PMC10881455 DOI: 10.1007/s11571-022-09918-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Neuropsychiatric disorders are one of the leading causes of disability. Mental health problems can occur due to various biological and environmental factors. The absence of definitive confirmatory diagnostic tests for psychiatric disorders complicates the diagnosis. It's critical to distinguish between bipolar disorder, depression, and schizophrenia since their symptoms and treatments differ. Because of brain-heart autonomic connections, electrocardiography (ECG) signals can be changed in behavioral disorders. In this research, we have automatically classified bipolar, depression, and schizophrenia from ECG signals. In this work, a new hand-crafted feature engineering model has been proposed to detect psychiatric disorders automatically. The main objective of this model is to accurately detect psychiatric disorders using ECG beats with linear time complexity. Therefore, we collected a new ECG signal dataset containing 3,570 ECG beats with four categories. The used categories are bipolar, depression, schizophrenia, and control. Furthermore, a new ternary pattern-based signal classification model has been proposed to classify these four categories. Our proposal contains four essential phases, and these phases are (i) multileveled feature extraction using multilevel discrete wavelet transform and ternary pattern, (ii) the best features selection applying iterative Chi2 selector, (iii) classification with artificial neural network (ANN) to calculate lead wise results and (iv) calculation the voted/general classification accuracy using iterative majority voting (IMV) algorithm. tenfold cross-validation is one of the most used validation techniques in the literature, and this validation model gives robust classification results. Using ANN with tenfold cross-validation, lead-by-lead and voted results have been calculated. The lead-by-lead accuracy range of the proposed model using the ANN classifier is from 73.67 to 89.19%. By deploying the IMV method, the general classification performance of our ternary pattern-based ECG classification model is increased from 89.19 to 96.25%. The findings and the calculated classification accuracies (single lead and voted) clearly demonstrated the success of the proposed ternary pattern-based advanced signal processing model. By using this model, a new wearable device can be proposed.
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Affiliation(s)
- Burak Tasci
- Vocational School of Technical Sciences, Firat University, 23119 Elazig, Turkey
| | - Gulay Tasci
- Department of Psychiatry, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Sengul Dogan
- Department of Digital Forensics Engineering, Technology Faculty, Firat University, Elazig, Turkey
| | - Turker Tuncer
- Department of Psychiatry, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
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Zhu L, Cui Q, Zhang Y, Liu F, Zhao J, Wang J. Sex-Specific Associations of Anxiety With Left Ventricular Hypertrophy and Transmural Dispersion of Repolarization in Hypertensive Patients. Front Cardiovasc Med 2022; 9:858097. [PMID: 35757339 PMCID: PMC9218101 DOI: 10.3389/fcvm.2022.858097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background The previous studies have shown that individuals with hypertension and anxiety have a higher mean left ventricular mass index (LVMI) and QTc dispersion. We explored the associations between anxiety and left ventricular hypertrophy (LVH) and between anxiety and transmural dispersion of repolarization (TDR) (as detected by T peak-T end interval/QT interval, Tp–Te/QT ratio) in patients with hypertension. Methods A total of 353 patients with uncomplicated hypertension from the Shaanxi Provincial People’s Hospital were enrolled between 2017 and 2021. Anxiety was defined as a Hamilton Anxiety Scale (HAM-A) score ≥ 14. Logistic regression models were used to estimate the association between HAM-A and LVH. The association between HAM-A score and Tp–Te/QT was estimated using linear regression. Results Participants were divided into two groups based on the presence of anxiety. LVMI was significantly higher in patients with hypertension and anxiety than in those with hypertension without anxiety (no anxiety: 84.36 ± 23.82, anxiety: 105.75 ± 25.45 g/m2, p < 0.001). HAM-A score was positively correlated with LVMI (r = 0.578, p < 0.001) and with Tp–Te/QT (r = 0.252, p < 0.001). Logistic regression models showed that patients with hypertension and anxiety were at higher risk of LVH than were patients with hypertension without anxiety (adjusted OR, 2.44, 95% CI, 1.35–4.43, p = 0.003). The linear regression analysis showed that the HAM-A score was associated with Tp–Te/QT ratio (adjusted β, 0.001, 95% CI, 0.001–0.002, p = 0.013). There was an interaction between sex and anxiety for LVH risk (p for interaction = 0.035) and for increased Tp–Te/QT (p for interaction = 0.014). After stratification by sex, anxiety was associated with increased risk for LVH in men with hypertension (adjusted OR, 5.56, 95% CI, 2.07–14.98, p = 0.001), but not in women (adjusted: OR, 1.44, 95% CI, 0.64–3.26, p = 0.377) with hypertension. The HAM-A score was also positively associated with Tp–Te/QT ratio in male (adjusted β, 0.002, 95% CI, 0.001–0.003, p < 0.001), but not in women (adjusted β, 0.001, 95% CI, –0.0002–0.002, p = 0.165). Conclusion Our results indicated that anxiety was associated with LVH and with increased TDR in men with hypertension, but not in women with hypertension.
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Affiliation(s)
- Ling Zhu
- Department of Cardiology, Shaanxi Provincial People’s Hospital, Xi’an, China
- Department of Cardiology, The Third Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qianwei Cui
- Department of Cardiology, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Yong Zhang
- Department of Cardiology, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Fuqiang Liu
- Department of Cardiology, Shaanxi Provincial People’s Hospital, Xi’an, China
- *Correspondence: Fuqiang Liu,
| | - Jingsha Zhao
- Department of Intensive Care Unit, Third People’s Hospital of Chengdu, Chengdu, China
- Jingsha Zhao,
| | - Junkui Wang
- Department of Cardiology, Shaanxi Provincial People’s Hospital, Xi’an, China
- Junkui Wang,
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Li XR, Zhang WH, Williams JP, Li T, Yuan JH, Du Y, Liu JD, Wu Z, Xiao ZY, Zhang R, Liu GK, Zheng GR, Zhang DY, Ma H, Guo QL, An JX. A multicenter survey of perioperative anxiety in China: Pre- and postoperative associations. J Psychosom Res 2021; 147:110528. [PMID: 34034140 DOI: 10.1016/j.jpsychores.2021.110528] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 05/17/2021] [Accepted: 05/17/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To describe patient characteristics associated with preoperative anxiety and subsequently assess the relationship between preoperative anxiety and postoperative anxiety, pain, sleep quality, nausea and vomiting. METHODS The study collected data from patients undergoing elective operation from 12 hospitals in China. The State-Trait Anxiety Inventory (STAI) and the Athens Insomnia Scale (AIS) were used to assess anxiety and sleep quality before surgery. Evaluations of anxiety, pain, sleep quality, nausea and vomiting were quantified using the Visual Analogue Scale on postoperative days 1 and 2. RESULTS Data from 997 patients were analyzed. Preoperatively, 258 (25.9%) patients had high anxiety (STAI-State>44). Multivariate analyses showed a significant relationship between high anxiety and female gender (OR: 1.66, 95% CI: 1.08-2.57, p = 0.02), highly invasive surgery (OR: 2.29, 95% CI: 1.29-4.06, p = 0.005), higher trait anxiety (OR: 1.24, 95% CI: 1.20-1.28, p < 0.001) and insomnia (AIS ≥ 6, OR: 1.79, 95% CI: 1.17-2.76, p = 0.008). Preoperative anxiety demonstrated a negative correlation with postoperative anxiety following highly invasive surgery; this became a positive relationship following less invasive surgery. Preoperative anxiety was also positively related to postoperative pain and poor sleep quality. The correlation between preoperative anxiety and postoperative nausea and vomiting was not statistically significant. CONCLUSION Female gender, highly invasive surgery, higher trait anxiety and insomnia are independent risk factors for high preoperative anxiety. Surgical invasiveness influences association between pre- and postoperative anxiety. Higher preoperative anxiety is related to poorer sleep quality and more severe pain postoperatively.
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Affiliation(s)
- Xi-Rong Li
- Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China; School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China
| | - Wen-Hao Zhang
- Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China
| | - John P Williams
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tong Li
- Department of Pain, Lanzhou Maternity and Child Healthcare Hospital, Lanzhou, Gansu, China
| | - Jian-Hu Yuan
- Department of Anesthesiology, Beijing Rectum Hospital, Beijing, China
| | - Yun Du
- Department of Anesthesiology, University of Chinese Academy of Sciences Affiliated Chongqing Hospital, Chongqing, China
| | - Jin-De Liu
- Department of Anesthesiology, University of Chinese Academy of Sciences Affiliated North China Hospital, Renqiu, Hebei, China
| | - Zhe Wu
- Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China
| | - Zhao-Yang Xiao
- Department of Anesthesiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Rui Zhang
- School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China
| | - Guo-Kai Liu
- Department of Anesthesiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Guan-Rong Zheng
- Department of Anesthesiology, Shengli Oilfield Central Hospital, Dongying, Shangdong, China
| | - Dong-Ya Zhang
- Department of Anesthesiology, Beijing Huaxin Hospital, The First Affiliated Hospital of Tsinghua University, Beijing, China
| | - Hong Ma
- Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qu-Lian Guo
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jian-Xiong An
- Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China; School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China.
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HARBALIOĞLU H, GENC O, ALICI G, QUİSİ A, YILDIRIM A. Features on ECG During Admission May Predict In-hospital Events for COVID-19 Patients. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.922646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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He CJ, Zhu CY, Han B, Hu HZ, Wang SJ, Zhai CL, Hu HL. Association between anxiety and clinical outcomes in Chinese patients with myocardial infarction in the absence of obstructive coronary artery disease. Clin Cardiol 2020; 43:659-665. [PMID: 32515510 PMCID: PMC7368297 DOI: 10.1002/clc.23386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) accounts for approximately 5% - 6% of acute myocardial infarction (AMI) patients. Anxiety symptoms are common in patients with coronary artery disease (CAD), and are associated with a poor prognosis. However, the association between anxiety and MINOCA outcomes is less clear. HYPOTHESIS Anxiety will be associated with clinical outcomes in patients with MINOCA. METHODS AND RESULTS Between November 2014 and December 2016, 620 hospitalized patients with MINOCA were recruited from a single center. Within 7 days of coronary angiography, anxiety was assessed using the Zung Self-Rating Anxiety Scale. The primary endpoint was all-cause mortality; secondary endpoint was any major adverse cardiovascular event (MACE). After 3 years, 87 deaths and 151 MACE had occurred. Kaplan-Meier curves indicated the unadjusted rates of all-cause mortality (log-rank P = .045) and MACE (log-rank P = .023) were significantly higher in the anxiety group compared with the control group of patients without anxiety. Multivariate Cox regression analysis showed that clinically significant anxiety was an independent prognostic factor for all-cause mortality as well as MACE (hazard ratio [HR] = 1.547; 95% confidence interval [CI], 1.006-2.380; P = .047; HR = 1.460; 95% CI, 1.049-2.031; P = .025; respectively). CONCLUSIONS Anxiety is significantly and independently associated with an increased risk of all-cause mortality and MACE in patients with MINOCA.
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Affiliation(s)
- Chao-Jie He
- Department of Cardiology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Chun-Yan Zhu
- Department of Psychology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Bin Han
- Department of Nephrology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Hai-Zhen Hu
- Department of Cardiology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Shi-Jun Wang
- Department of Cardiology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Chang-Lin Zhai
- Department of Cardiology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Hui-Lin Hu
- Department of Cardiology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
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Demirhan A, Velioglu Y, Yoldas H, Karagoz I, Cosgun M, Caliskan D, Yildiz I, Bilgi M, Erdem K. An Easy and Reliable Way to Prevent Electrocardiographic Deteriorations of Patients Undergoing Off-Pump Coronary Artery Bypass Surgery: Preoperative Anxiolytic Treatment. Braz J Cardiovasc Surg 2019; 34:311-317. [PMID: 31310470 PMCID: PMC6629217 DOI: 10.21470/1678-9741-2018-0282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate the effects of preoperative anxiety relieving on electrophysiological changes in patients undergoing off-pump coronary artery bypass surgery. METHODS A total of 61 patients at ASA III risk group in the age range of 18-65 years were enrolled in the present study. Patients were randomly divided into two groups. Group S (Sedation group) was administered 0.04 mg/kg lorazepam per os (PO) twice before the operation. Group C (control group) was not administered with any anxiolytic premedication. State Trait Anxiety Inventory (STAI-I) and Beck Anxiety Inventory (BAI) were used to evaluate the level of anxiety. Electrocardiography (ECG), pulse oximeter and standard monitoring were performed for each patient. QT and P dispersions in each derivation of all ECGs were calculated. RESULTS Preoperative STAI-I scores were significantly lower in sedation group compared to the controls. Mean values of QT dispersion measured before induction, at the 1st minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.024; P=0.027; P=0.001; P=0.033, respectively). The mean values of P dispersion measured before induction, at the 3rd minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.001; P=0.020; P=0.023; P=0.005, respectively). CONCLUSION Elevated anxiety levels in patients undergoing coronary bypass surgery have a negative effect through prolonged QT and P-wave dispersion times. Anxiolytic treatment before surgery may be useful to prevent ventricular and atrial arrhythmias and associated complications through decreasing the QT and P-wave dispersion duration.
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Affiliation(s)
- Abdullah Demirhan
- Abant Izzet Baysal University Medical School Department of Anesthesiology and Reanimation Bolu Turkey Department of Anesthesiology and Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey
| | - Yusuf Velioglu
- Abant Izzet Baysal University Medical School Bolu Turkey Department of Cardiovascular Surgery, Abant Izzet Baysal University Medical School, Bolu, Turkey
| | - Hamit Yoldas
- Abant Izzet Baysal University Medical School Department of Anesthesiology and Reanimation Bolu Turkey Department of Anesthesiology and Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey
| | - Ibrahim Karagoz
- Abant Izzet Baysal University Medical School Department of Anesthesiology and Reanimation Bolu Turkey Department of Anesthesiology and Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey
| | - Mehmet Cosgun
- Abant Izzet Baysal University Medical School Department of Cardiology Bolu Turkey Department of Cardiology, Abant Izzet Baysal University Medical School, Bolu, Turkey
| | - Duygu Caliskan
- Abant Izzet Baysal University Medical School Department of Anesthesiology and Reanimation Bolu Turkey Department of Anesthesiology and Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey
| | - Isa Yildiz
- Abant Izzet Baysal University Medical School Department of Anesthesiology and Reanimation Bolu Turkey Department of Anesthesiology and Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey
| | - Murat Bilgi
- Abant Izzet Baysal University Medical School Department of Anesthesiology and Reanimation Bolu Turkey Department of Anesthesiology and Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey
| | - Kemalettin Erdem
- Abant Izzet Baysal University Medical School Bolu Turkey Department of Cardiovascular Surgery, Abant Izzet Baysal University Medical School, Bolu, Turkey
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Tolentino JC, Schmidt SL. Association between depression and cardiovascular disease: A review based on QT dispersion. Eur J Prev Cardiol 2019; 26:1568-1570. [PMID: 30813819 DOI: 10.1177/2047487319833509] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Julio C Tolentino
- Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sergio L Schmidt
- Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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Eshraghi A, Hoseinjani E, Jalalyazdi M, Vojdanparast M, Jafarzadeh-Esfehani R. QT interval and P wave dispersion in slow coronary flow phenomenon. ARYA ATHEROSCLEROSIS 2019; 14:212-217. [PMID: 30783411 PMCID: PMC6368196 DOI: 10.22122/arya.v14i5.1599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Slow coronary flow (SCF) phenomenon is an angiographic finding which is defined as slow contrast passage through coronary arteries which may predispose patients to serious cardiac complications such as fatal arrhythmias. P-wave and QT-interval dispersion are electrocardiographic findings which are related to atrial fibrillation and ventricular tachyarrhythmias. In the present study, the relation between SCF and presence of P-wave and QT-interval dispersion in electrocardiography has been evaluated. METHODS 47 patients with normal coronary arteries and SCF and 40 patients with normal coronary artery flow without SCF were enrolled in this case control study. Standard electrocardiogram (ECG) was analyzed for P-wave and QT-interval dispersion. SCF was identified in normal coronary vessels by use of Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) method (TFC > 27). Corrected TIMI frame count (CTFC) of coronary vessels as well as mean CTFC along with QT-interval and P-wave dispersion were compared between 2 groups. The study data were analyzed by SPSS software and P value less than 0.050 was considered to be significant. RESULTS QT-interval [76.17 (35.23) ms versus 39.25 (19.26) ms] and P-wave [39.74 (17.48) ms versus 19.50 (8.54) ms] dispersion were significantly higher among patients with SCF phenomenon (P < 0.050). In addition, there was a positive significant linear correlation between TFC and P-wave and QT-dispersion (r = 0.857, r = 0.861, respectively, P < 0.050). CONCLUSION According to the results, increasing TFC among patients with SCF will result in P wave and QT interval dispersion and therefore this finding can be considered as an indicative marker for cardiac events.
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Affiliation(s)
- Ali Eshraghi
- Associate Professor, Department of Cardiovascular Diseases, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Emadoddin Hoseinjani
- Resident, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Jalalyazdi
- Assistant Professor, Department of Cardiovascular Diseases, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Vojdanparast
- Cardiologist, Department of Cardiovascular Diseases, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Jafarzadeh-Esfehani
- PhD Candidate, Medical Genetics Research Center, Basic Medical Sciences Institute, Mashhad University of Medical Sciences, Mashhad, Iran
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Pishgahi M, Dadkhahfar S, Robati RM, Kheradmand Z, Shahidi-Dadras M, Zargari O, Elpern DJ. Electrocardiographic changes after high-dose corticosteroid pulse therapy in pemphigus patients. J DERMATOL TREAT 2018; 29:802-805. [PMID: 29668335 DOI: 10.1080/09546634.2018.1466980] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE The objective of the current study was to evaluate the effect of intravenous methylprednisolone pulse therapy on myocardial repolarization alterations, especially QT dispersion in anticipation of cardiovascular risks in patients with pemphigus vulgaris. METHODS The current study is a prospective-controlled study on the electrocardiographic changes after methylprednisolone pulse therapy in 50 patients with pemphigus vulgaris. RESULTS A total of 50 patients (28 female and 22 male) were included in our study. The mean heart rate was significantly higher in male patients both before (92 ± 10.80 versus 82.75 ± 12.01 ms) and after pulse therapy (102.73 ± 14.26 versus 91.07 ± 15.02 ms) (p value < .01). The value of heart rate was significantly greater after receiving steroid pulse therapy. Corrected QT dispersion before pulse therapy was 19.92 ± 8.2 ms that increased to 40.68 ± 18.12 ms after treatment (p value < .001). CONCLUSION Our study shows that there is a relationship between pulse steroid infusion and increased predisposition to the occurrence of cardiac arrhythmias. QT dispersion could be a good marker to assess this risk in these patients.
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Affiliation(s)
- Mehdi Pishgahi
- a Department of Cardiology , Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Sahar Dadkhahfar
- b Skin Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Reza M Robati
- b Skin Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Zohreh Kheradmand
- b Skin Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
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Tolunay T, Bicici V, Tolunay H, Akkurt MO, Arslan AK, Aydogdu A, Bingol I. Rhythm and orthopedics: The effect of music therapy in cast room procedures, a prospective clinical trial. Injury 2018; 49:593-598. [PMID: 29454656 DOI: 10.1016/j.injury.2018.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/02/2018] [Accepted: 02/06/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Cast room procedures generally cause anxiety in patients. Anxiety complicates the procedure as well as increases the risk of a complication. Listening to music was found to be the safest and most common non-drug treatment method. The aim of this study is to evaluate the effect of listening to music on adult patients in cast room procedures. This study points out the relation between anxiety and anxiety relevant cardiac arrhythmia. MATERIALS AND METHODS The study was performed on 199 patients with stable general condition, aged above 18. The patients were divided into two groups. Randomization method used in the study was coin flip. The first group (Group 1) listened to music during cast room procedures whereby the second group (Group 2) did not listen to music. Length of the procedure, complication, blood pressure and heart rate evaluations before and after the procedure, Visual Analogue Scale (VAS scores for pain), State-Trait Anxiety Inventory (STAI) anxiety score, patient satisfaction, willingness of the patient to repeat the procedure, P wave dispersion (Pd) and corrected QT interval dispersion (QTcd) as electrocardiographic arrhythmia predictors were evaluated. The Clinical Research Ethics Committee approval was obtained for this study. RESULTS Significant difference was shown between the two groups for the following criteria: VAS scores (p = 0.005), anxiety scores (p = 0.032), processing time (p = 0.027), and QTcd values (p = 0.031). Patient satisfaction (p < 0.001) and willingness to repeat the procedure (p < 0.001) were higher for the group who listened to music. No significant difference in Pd values, blood pressure and heart rate was reported within the groups. CONCLUSION Music therapy is a non-invasive, safe, nonpharmacologic, anxiolytic, and analgesic treatment. Music therapy should become standard protocol in cast room procedures. One of the most important achievements of this study was the fact that music decreases anxiety and anxiety-related cardiac arrhythmia. Therefore, conducting further prospective studies including high cardiac risk patients especially with arrhythmia is crucial.
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Affiliation(s)
- Tolga Tolunay
- Department of Orthopaedics, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Yeni Batı Mah.2367.sokak No:4, Batıkent, Yenimahalle, 06370, Ankara, Turkey.
| | - Vedat Bicici
- Department of Orthopaedics, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Yeni Batı Mah.2367.sokak No:4, Batıkent, Yenimahalle, 06370, Ankara, Turkey.
| | - Hatice Tolunay
- Department of Cardiology, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Yeni Batı Mah.2367.sokak No:4, Batıkent, Yenimahalle, 06370, Ankara, Turkey.
| | - Mehmet Orcun Akkurt
- Department of Orthopaedics, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Yeni Batı Mah.2367.sokak No:4, Batıkent, Yenimahalle, 06370, Ankara, Turkey.
| | - Arslan Kagan Arslan
- Department of Orthopaedics, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Yeni Batı Mah.2367.sokak No:4, Batıkent, Yenimahalle, 06370, Ankara, Turkey.
| | - Ali Aydogdu
- Department of Orthopaedics, Hitit University Corum Training and Research Hospital, Cepni Mah.Inonu Caddesi No:176, Corum, Turkey.
| | - Izzet Bingol
- Department of Orthopaedics, 29 Mayis State Hospital, Aydinlar Mah., Dikmen Cad. No: 312, Cankaya, 06105, Ankara, Turkey.
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Carnevali L, Rivara S, Nalivaiko E, Thayer JF, Vacondio F, Mor M, Sgoifo A. Pharmacological inhibition of FAAH activity in rodents: A promising pharmacological approach for psychological—cardiac comorbidity? Neurosci Biobehav Rev 2017; 74:444-452. [DOI: 10.1016/j.neubiorev.2016.04.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/19/2016] [Accepted: 04/20/2016] [Indexed: 01/09/2023]
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Kyrou I, Kollia N, Panagiotakos D, Georgousopoulou E, Chrysohoou C, Tsigos C, Randeva HS, Yannakoulia M, Stefanadis C, Papageorgiou C, Pitsavos C. Association of depression and anxiety status with 10-year cardiovascular disease incidence among apparently healthy Greek adults: The ATTICA Study. Eur J Prev Cardiol 2016; 24:145-152. [DOI: 10.1177/2047487316670918] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ioannis Kyrou
- Department of Science of Dietetics and Nutrition, Harokopio University, Greece
- Aston Medical Research Institute, Aston University, UK
- Translational and Experimental Medicine, Division of Biomedical Sciences, University of Warwick, UK
- WISDEM, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Natasa Kollia
- Department of Science of Dietetics and Nutrition, Harokopio University, Greece
| | | | | | | | - Constantine Tsigos
- Department of Science of Dietetics and Nutrition, Harokopio University, Greece
| | - Harpal S Randeva
- Aston Medical Research Institute, Aston University, UK
- Translational and Experimental Medicine, Division of Biomedical Sciences, University of Warwick, UK
- WISDEM, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Mary Yannakoulia
- Department of Science of Dietetics and Nutrition, Harokopio University, Greece
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Tolentino JC, Schmidt SL. Association between depression severity and cardiac autonomic modulation. J Psychosom Res 2016; 85:9-11. [PMID: 27212663 DOI: 10.1016/j.jpsychores.2016.03.125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 03/25/2016] [Accepted: 03/30/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Changes in autonomic modulation are found in depressive patients. QT dispersion is a convenient measure of cardiac autonomic modulation (CAM). As both QT dispersion and depression are related to changes in CAM, this study aimed to examine if there was an association between depression severity and QT dispersion. METHODS The selected sample (n=60) derived from 236 women who were recruited via a campaign for breast cancer prevention. The women selected to participate were all non-smokers and were not taking any drug that could interfere with the results. After applying inclusion and exclusion criteria, 60 women were selected. QT dispersion (QTd) and rate-corrected QTd (QTcD) were calculated in 37 physically and mentally healthy women and 23 nontreated depressive women. Univariate ANOVA(s) were used to test group differences. The 17-item Hamilton Depression Rating Scale (HDRS17) was scored to measure depression severity. The relationship between depression severity and cardiac autonomic modulation was analyzed by the best curve that fit the raw data of the HDRS17 scores and the QT dispersion variables. RESULTS The QTd and QTcD were significantly smaller in non-depressed in relation to the depressed women. The best curve that fit the raw data of depression severity (HDRS17) and the two measurements of cardiac autonomic modulation (QTd and QTcD) was a cubic equation for both QTd and QTcD. An increase in QTd and QTcD were observed until the HDRS17 score reached 20 points. CONCLUSION There is a significant positive relationship between depression severity and cardiac autonomic modulation in mild and moderate depression.
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Affiliation(s)
- J C Tolentino
- Federal University of the State of Rio de Janeiro (UNIRIO), Neurology Post-Graduate Program, Brazil.
| | - S L Schmidt
- Federal University of the State of Rio de Janeiro (UNIRIO), Neurology Post-Graduate Program, Brazil; State University of Rio de Janeiro (UERJ), Brazil; Federal University of Juiz de Fora (UFJF), Brazil.
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Carnevali L, Vacondio F, Rossi S, Macchi E, Spadoni G, Bedini A, Neumann ID, Rivara S, Mor M, Sgoifo A. Cardioprotective effects of fatty acid amide hydrolase inhibitor URB694, in a rodent model of trait anxiety. Sci Rep 2015; 5:18218. [PMID: 26656183 PMCID: PMC4677398 DOI: 10.1038/srep18218] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/02/2015] [Indexed: 12/12/2022] Open
Abstract
In humans, chronic anxiety represents an independent risk factor for cardiac arrhythmias and sudden death. Here we evaluate in male Wistar rats bred for high (HAB) and low (LAB) anxiety-related behavior, as well as non-selected (NAB) animals, the relationship between trait anxiety and cardiac electrical instability and investigate whether pharmacological augmentation of endocannabinoid anandamide-mediated signaling exerts anxiolytic-like and cardioprotective effects. HAB rats displayed (i) a higher incidence of ventricular tachyarrhythmias induced by isoproterenol, and (ii) a larger spatial dispersion of ventricular refractoriness assessed by means of an epicardial mapping protocol. In HAB rats, acute pharmacological inhibition of the anandamide-degrading enzyme, fatty acid amide hydrolase (FAAH), with URB694 (0.3 mg/kg), (i) decreased anxiety-like behavior in the elevated plus maze, (ii) increased anandamide levels in the heart, (iii) reduced isoproterenol-induced occurrence of ventricular tachyarrhythmias, and (iv) corrected alterations of ventricular refractoriness. The anti-arrhythmic effect of URB694 was prevented by pharmacological blockade of the cannabinoid type 1 (CB1), but not of the CB2, receptor. These findings suggest that URB694 exerts anxiolytic-like and cardioprotective effects in HAB rats, the latter via anandamide-mediated activation of CB1 receptors. Thus, pharmacological inhibition of FAAH might be a viable pharmacological strategy for the treatment of anxiety-related cardiac dysfunction.
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Affiliation(s)
| | | | - Stefano Rossi
- Department of Life Sciences, University of Parma, Italy
| | - Emilio Macchi
- Department of Life Sciences, University of Parma, Italy
| | - Gilberto Spadoni
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Italy
| | - Annalida Bedini
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Italy
| | - Inga D Neumann
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, Germany
| | | | - Marco Mor
- Department of Pharmacy, University of Parma, Italy
| | - Andrea Sgoifo
- Department of Neuroscience, University of Parma, Italy
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Obstructive sleep apnea and increased QT dispersion. SOMNOLOGIE 2015. [DOI: 10.1007/s11818-015-0013-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Izci F, Hocagil H, Izci S, Izci V, Koc MI, Acar RD. P-wave and QT dispersion in patients with conversion disorder. Ther Clin Risk Manag 2015; 11:475-80. [PMID: 25848293 PMCID: PMC4381888 DOI: 10.2147/tcrm.s81852] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate QT dispersion (QTd), which is the noninvasive marker of ventricular arrhythmia and sudden cardiac death, and P-wave dispersion, which is the noninvasive marker of atrial arrhythmia, in patients with conversion disorder (CD). PATIENTS AND METHODS A total of 60 patients with no known organic disease who were admitted to outpatient emergency clinic and were diagnosed with CD after psychiatric consultation were included in this study along with 60 healthy control subjects. Beck Anxiety Inventory and Beck Depression Scale were administered to patients and 12-lead electrocardiogram measurements were obtained. Pd and QTd were calculated by a single blinded cardiologist. RESULTS There was no statistically significant difference in terms of age, sex, education level, socioeconomic status, weight, height, and body mass index between CD patients and controls. Beck Anxiety Inventory scores (25.2±10.8 and 3.8±3.2, respectively, P<0.001) and Beck Depression Scale scores (11.24±6.15 and 6.58±5.69, respectively, P<0.01) were significantly higher in CD patients. P-wave dispersion measurements did not show any significant differences between conversion patients and control group (46±5.7 vs 44±5.5, respectively, P=0.156). Regarding QTc and QTd, there was a statistically significant increase in all intervals in conversion patients (416±10 vs 398±12, P<0.001, and 47±4.8 vs 20±6.1, P<0.001, respectively). CONCLUSION A similar relation to that in literature between QTd and anxiety and somatoform disorders was also observed in CD patients. QTc and QTd were significantly increased compared to the control group in patients with CD. These results suggest a possibility of increased risk of ventricular arrhythmia resulting from QTd in CD patients. Larger samples are needed to evaluate the clinical course and prognosis in terms of arrhythmia risk in CD patients.
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Affiliation(s)
- Filiz Izci
- Department of Psychiatry, Istanbul Bilim University, Sısli Florence Nightingale Hospital, Zonguldak, Turkey
| | - Hilal Hocagil
- Department of Emergency, Faculty of Medicine Hospital Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Servet Izci
- Department of Cardiology, Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Vedat Izci
- Department of Emergency, Kartal Training and Research Hospital, Istanbul, Turkey
| | - Merve Iris Koc
- Department of Psychiatry, Erenköy Training and Research Hospital for Psychiatry, Istanbul, Turkey
| | - Rezzan Deniz Acar
- Department of Cardiology, Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
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