1
|
Ozturk HM, Erdogan M, Turan Y, Celik IE, Ozturk S. Left atrial function index and left atrial electromechanical functions in anxiety disorders. Acta Cardiol 2024:1-9. [PMID: 38572756 DOI: 10.1080/00015385.2024.2336345] [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: 08/25/2023] [Accepted: 03/17/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND There is a close linkage between anxiety disorders (ADs), and development of cardiovascular disease (CVD) and atrial fibrillation (AF). We aimed to investigate left atrial function index (LAFI) and its components, LA mechanical functions and atrial conduction times in AD patients and age- and gender-matched control group patients for the first time in the literature. METHODS A total of 48 AD patients and 33 healthy subjects were enrolled to the study prospectively. Echocardiographic parameters including two-dimensional conventional echocardiography, diastolic functions, LA mechanical functions, LAFI, atrial conduction times and atrial electromechanical delay (AEMD) were calculated. RESULTS The velocity-time integral of the LV outflow tract (LVOT-VTI), LAFI and LA conduit volume were significantly lower in AD patients. Atrial electromechanical coupling as established from lateral mitral annulus (PA lateral) was significantly higher in AD group than control group. Inter-AEMD and left intra-AEMD were also higher in AD group compared to control group. Age, gender, body surface area (BSA), conduit volume, LVOT-VTI and LAFI were significant factors associated with AD in univariate analysis. However, only BSA and LVOT-VTI (Odds ratio [OR]: 0.79, 95 CI%: 0.66-0.95, p = 0.013) were independently associated with AD in multivariate analysis. Age, gender, conduit volume and LAFI (OR: 0.25, 95 CI%: 0.03-2.12, p = 0.204) were not found to be independent associates of AD. CONCLUSION LAFI is impaired in patients suffering from AD compared to their age- and gender-matched counterparts but this impairment originates from lower levels of LVOT-VTI calculations in AD patients. Thus, LVOT-VTI, but not LAFI, is independently associated with AD.
Collapse
Affiliation(s)
| | - Mehmet Erdogan
- Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Yasar Turan
- Department of Cardiology, Istanbul Yeni Yuzyıl University Faculty of Medicine, Istanbul, Turkey
| | - Ibrahim Etem Celik
- Department of Cardiology, Ankara Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Selcuk Ozturk
- Department of Cardiology, Kırıkkale Yuksek Ihtisas Hospital, Kırıkkale, Turkey
| |
Collapse
|
2
|
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.
Collapse
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,
| |
Collapse
|
3
|
Chen X, Xu L, Li Z. Autonomic Neural Circuit and Intervention for Comorbidity Anxiety and Cardiovascular Disease. Front Physiol 2022; 13:852891. [PMID: 35574459 PMCID: PMC9092179 DOI: 10.3389/fphys.2022.852891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/21/2022] [Indexed: 11/28/2022] Open
Abstract
Anxiety disorder is a prevalent psychiatric disease and imposes a significant influence on cardiovascular disease (CVD). Numerous evidence support that anxiety contributes to the onset and progression of various CVDs through different physiological and behavioral mechanisms. However, the exact role of nuclei and the association between the neural circuit and anxiety disorder in CVD remains unknown. Several anxiety-related nuclei, including that of the amygdala, hippocampus, bed nucleus of stria terminalis, and medial prefrontal cortex, along with the relevant neural circuit are crucial in CVD. A strong connection between these nuclei and the autonomic nervous system has been proven. Therefore, anxiety may influence CVD through these autonomic neural circuits consisting of anxiety-related nuclei and the autonomic nervous system. Neuromodulation, which can offer targeted intervention on these nuclei, may promote the development of treatment for comorbidities of CVD and anxiety disorders. The present review focuses on the association between anxiety-relevant nuclei and CVD, as well as discusses several non-invasive neuromodulations which may treat anxiety and CVD.
Collapse
Affiliation(s)
- Xuanzhao Chen
- The Center of Pathological Diagnosis and Research, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Li Xu
- Department of Rheumatology and Immunology, General Hospital of Central Theater Command, Wuhan, China
| | - Zeyan Li
- The Center of Pathological Diagnosis and Research, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| |
Collapse
|
4
|
Huang KY, Chang CH, Yu KC, Hsu CH. Assessment of quality of life and activities of daily living among elderly patients with hypertension and impaired physical mobility in home health care by antihypertensive drugs plus acupuncture: A CONSORT-compliant, randomized controlled trial. Medicine (Baltimore) 2022; 101:e29077. [PMID: 35356935 PMCID: PMC10684176 DOI: 10.1097/md.0000000000029077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 02/24/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To evaluate the efficacy of acupuncture in improving quality of life (QOL) and activities of daily living among elderly patients with hypertension and impaired physical mobility in home health care. METHODS Seventy participants were allocated randomly to receive either acupuncture together with antihypertensive drugs (n = 35) or antihypertensive drugs only (n = 35). Acupuncture was conducted twice a week for 12 consecutive weeks, each lasting 30 minutes. Acupuncture points San Yin Jiao, Xue Hai, Taichong, Zusanli, and Hegu acupuncture points were used bilaterally. The primary outcome was change in QOL score, evaluating by Short-Form 36 Item Health Survey (SF-36). Secondary outcomes were changes in Barthel index score and blood pressure. Besides, pain evaluation by Visual analog scale, among acupuncture and control subgroups in participants with diagnosis with disease of the musculoskeletal system and connective tissue (ICD-9: 710-739). RESULTS Thirty-one participants in each of the acupuncture group and the control group completed the study. After 12 weeks of treatment, compared with the control group, the combination of antihypertensive treatments and acupuncture helped to improve bodily pain (P = .03), physical component summary (P = .04), mental health (P < .001), mental component summary (P = .008), Barthel index (P = .02), and systolic blood pressure (P = .01). In contrast, the control group showed no significant changes. Change in pain score revealed that there were a significant between-group differences after 6weeks (P = .01) and 12weeks of treatment (P = .001). CONCLUSION The results of the study suggested that in home health care elderly patients with hypertension and impaired physical mobility, antihypertensive drugs combined with acupuncture therapy will be more beneficial to improve QOL, activities of daily living, and blood pressure.
Collapse
Affiliation(s)
| | | | | | - Chung-Hua Hsu
- Correspondence: Chung-Hua Hsu, Institute of Traditional Medicine, National Yang-Ming Chiao Tung University, No. 155, Sec 2, Li-Nong Street, Beitou District, Taipei 112, Taiwan (e-mail: ).
| |
Collapse
|
5
|
Andrade EF, Pereira LJ, Oliveira APLD, Orlando DR, Alves DAG, Guilarducci JDS, Castelo PM. Perceived fear of COVID-19 infection according to sex, age and occupational risk using the Brazilian version of the Fear of COVID-19 Scale. DEATH STUDIES 2022; 46:533-542. [PMID: 32845795 DOI: 10.1080/07481187.2020.1809786] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
We investigated the fear of COVID-19 infection after proper translation and cultural adaptation of the "Fear of COVID-19 Scale" to the Brazilian Portuguese language. A sample of 1,743 Brazilian participants were included. The scale showed excellent psychometric characteristics. Women showed higher anxiety levels. Fear of COVID-19 scores were lower in males with occupational risk of contamination. On the other hand, women and younger individuals showed higher fear of COVID-19 infection scores. The Brazilian Fear of COVID-19 Scale proved to be a reliable tool with excellent psychometric properties for identifying fear of COVID-19 infection in the Brazilian population.
Collapse
Affiliation(s)
- Eric Francelino Andrade
- Departamento de Medicina Veterinária, Physiology Area, Agrarian Sciences Institute, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Unaí, Brazil
| | - Luciano José Pereira
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Brazil
| | - Ana Paula Luiz de Oliveira
- Department of Preventive Veterinary Medicine and Animal Reproduction, Universidade Estatual Paulista, Jaboticabal, Brazil
| | - Débora Ribeiro Orlando
- Departamento de Medicina Veterinária, Physiology Area, Agrarian Sciences Institute, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Unaí, Brazil
| | | | | | - Paula Midori Castelo
- Department Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| |
Collapse
|
6
|
Byrne D, Kahl KG, Alvarenga ME. Editorial: Psychocardiology then and now - the genesis of a discipline. Front Psychiatry 2022; 13:988393. [PMID: 36051553 PMCID: PMC9427029 DOI: 10.3389/fpsyt.2022.988393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Don Byrne
- College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Kai G Kahl
- Department for Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Marlies E Alvarenga
- Department of Psychology, Institute of Health and Wellbeing, Federation University Australia, Melbourne, VIC, Australia
| |
Collapse
|
7
|
Turan Kavradim S, Yangöz ŞT, Ozer Z. Effectiveness of aromatherapy inhalation on anxiety and haemodynamic variables for patients with cardiovascular disease: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14593. [PMID: 34309971 DOI: 10.1111/ijcp.14593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Anxiety can negatively affect patients' prognosis in cardiovascular disease. Aromatherapy helps reduce anxiety level in chronic diseases. However, the effectiveness of aromatherapy on anxiety and haemodynamic variables remains uncertain. OBJECTIVE To evaluate the evidence for the effectiveness of aromatherapy on anxiety and haemodynamic variables in patients with cardiovascular disease. DESIGN A systematic review and meta-analysis. REVIEW METHODS The CINAHL COMPLETE, Cochrane Central, Web of Science, Pubmed, Scopus, Science Direct, Ovid and ProQuest databases were searched. The study was conducted in line with the Cochrane and PRISMA guideline. Examination for bias in the included studies was conducted with the Cochrane bias guideline. Heterogeneity and publication bias were evaluated. RESULTS Twelve studies published from 2012 to 2020 were included in the meta-analysis. Lavender aromatherapy inhalation was used the most for anxiety in patients. Aromatherapy had a highly significant effect on anxiety, systolic blood pressure and heart rate, a moderate effect on breathing rate and a non-significant effect on diastolic blood pressure. The Cochrane GRADE approach was used to assess the rating of the certainty of evidence. A high level of evidence was found for the effect of aromatherapy on heart rate, a moderate level for the effect of aromatherapy on anxiety and breathing rate and a low level for the effects of aromatherapy on blood pressure and lavender on anxiety. CONCLUSION It was found that aromatherapy reduced anxiety, systolic blood pressure, heart rate and breathing rate in patients with cardiovascular disease. This study provides information to researchers and health professionals about the effectiveness of aromatherapy on decreasing anxiety and haemodynamic variables in patients with cardiovascular disease. Also, the study can contribute to planning studies which are better designed, conducted and reported.
Collapse
Affiliation(s)
- Selma Turan Kavradim
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Şefika Tuğba Yangöz
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey
| | - Zeynep Ozer
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| |
Collapse
|
8
|
MUSTAȚĂ AE. "The Relationships between Coping Mechanisms, Depression,
Anxiety and Sleep Disorders in Cardiovascular Patients". JOURNAL OF EVIDENCE-BASED PSYCHOTHERAPIES 2021. [DOI: 10.24193/jebp.2021.1.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
"Depression, anxiety and sleep disorders are psychological risk factors that
could impact the quality of life in cardiovascular patients. In this study, a
theoretical model on the complex relationships between coping mechanisms,
depression, anxiety and sleep disorders was studied in a sample of 274
cardiovascular patients. The maladaptive cognitive-emotional coping
strategies that appeared to be correlated with these negative emotional
pathologies were self-blaming, ruminating and catastrophizing, and the
adaptive ones were positive refocusing, refocusing on planning and positive
reassessment. A theoretical model that explains these relationships at a
process level appears to have statistical significance and to have adequate
goodness of fit. In this model, there are statistically significant direct effects
of maladaptive and adaptive coping mechanisms on depression and anxiety,
a significant effect of anxiety on depression, as well as statistically
significant positive effects of depression and anxiety on sleep disorders. The
age has been controlled for in the model and the severity of the illness
appears to have a moderating role in this context, with a stronger effect of
anxiety on depression for patients with more severe illnesses. The practical
implications of these results in psychological counselling addressed to
cardiovascular patients are discussed."
Collapse
Affiliation(s)
- Andreea E. MUSTAȚĂ
- University of Bucharest, Faculty of Psychology and Educational Sciences, Panduri Street, no 90, sector 5, Bucharest, Romania
| |
Collapse
|
9
|
Dutt R, Shankar N, Srivastava S, Yadav A, Ahmed RS. Cardiac autonomic tone, plasma BDNF levels and paroxetine response in newly diagnosed patients of generalised anxiety disorder. Int J Psychiatry Clin Pract 2020; 24:135-142. [PMID: 32022607 DOI: 10.1080/13651501.2020.1723642] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: The study examined the effect on cardiac autonomic tone via heart rate variability (HRV), brain derived neurotrophic factor (BDNF) in newly diagnosed generalised anxiety disorder (GAD) cases with paroxetine-controlled release (PX) CR intervention.Methods: Fifty GAD cases using DSM-5 criteria, matched with healthy controls (HC) were assessed with clinical measures (Hamilton Anxiety Scale (HAM-A), Clinical Global Impression- Severity Scale (CGI-Severity), General Health Questionnaire -12 (GHQ-12), HRV, plasma BDNF levels initially and 6 weeks postintervention with paroxetine CR.Results: HRV parameters were significantly lower in GAD vs HC at baseline for standard deviation of normal to normal intervals (SDNN) and proportion of differences in consecutive NN intervals that are longer than 50 ms (pNN50). Significantly higher plasma BDNF levels were noted between HC versus GAD at baseline. Postintervention HAM-A, CGI scores, GHQ-12 item scores showed significant reduction. Significant differences also noted in square root of mean squared difference of successive NN intervals (RMSSD), (SDNN), pNN50 and in plasma BDNF levels after intervention within GAD group. Significant negative correlation observed between HAM-A scores and SDNN parameter after taking PX CR in GAD.Conclusion: GAD showed cardiac autonomic dysfunction, lowered plasma BDNF levels and their improvement with paroxetine CR.Key messageGAD is associated with significantly lower HRV, suggestive of cardiac autonomic dysfunction and lowered plasma BDNF levels, an indicator of stress.Therapeutic intervention with Paroxetine in GAD patients showed clinically significant improvement reflecting restoration of the cardiac autonomic tone and BDNF levels, thus implying their role as potential biomarkers.
Collapse
Affiliation(s)
- Ravi Dutt
- Department of Physiology, University College of Medical sciences and GTB Hospital, Delhi, India
| | - Nilima Shankar
- Department of Physiology, University College of Medical sciences and GTB Hospital, Delhi, India
| | - Shruti Srivastava
- Department of Psychiatry, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Asha Yadav
- Department of Physiology, University College of Medical sciences and GTB Hospital, Delhi, India
| | - Rafat S Ahmed
- Department of Biochemistry, University College of Medical Sciences and GTB Hospital, Delhi, India
| |
Collapse
|
10
|
Fonseca NKDOD, Molle RD, Costa MDA, Gonçalves FG, Silva AC, Rodrigues Y, Price M, Silveira PP, Manfro GG. Impulsivity influences food intake in women with generalized anxiety disorder. ACTA ACUST UNITED AC 2020; 42:382-388. [PMID: 32074229 PMCID: PMC7430399 DOI: 10.1590/1516-4446-2019-0556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 11/04/2019] [Indexed: 01/11/2023]
Abstract
Objective: Eating behavior is affected by psychological and neurocognitive factors. However, little is known about this relationship in anxious patients. Our aim was to investigate the associations between impulsivity, inhibitory control, energy-dense food consumption, and body mass index (BMI) in women with generalized anxiety disorder (GAD). Methods: In this cross-sectional study, 51 adult females with GAD answered the Barratt Impulsiveness Scale (BIS-11) and participated in a go/no-go task using food images. Anthropometric measurements were evaluated. A food frequency questionnaire and a snack test were used to study eating behavior. Pearson correlation and multiple linear regression were performed to analyze the variables of interest, adjusted by age. Results: Impulsivity predicted intake of sugar (p = 0.016, 95%CI 0.67-6.05), total fat (p = 0.007, 95%CI 0.62-3.71), and saturated fat (p = 0.004, 95%CI 0.30-1.48). The snack test showed a positive correlation between presence of impulsivity and intake of biscuits (R = 0.296; p = 0.051). Response inhibition to food images in the go/no-go task paradigm did not predict BMI or food intake. Conclusion: Impulsivity was predictive of higher sugar and saturated fat intake in women diagnosed with GAD. Our findings add to the literature regarding the association between neuropsychological factors and food consumption in this specific population.
Collapse
Affiliation(s)
- Natasha Kim de O da Fonseca
- Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Roberta D Molle
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, UFRGS, Porto Alegre, RS, Brazil
| | - Marianna de A Costa
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Francine G Gonçalves
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Alice C Silva
- Graduação em Nutrição, UFRGS, Porto Alegre, RS, Brazil
| | | | - Menna Price
- Department of Psychology, Swansea University, Swansea, Wales, UK
| | - Patrícia P Silveira
- Department of Psychiatry and Sackler Program for Epigenetics & Psychobiology, McGill University, Montreal, Quebec, Canada
| | - Gisele G Manfro
- Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
11
|
Illness perception in overweight and obese patients with cardiovascular diseases. Eat Weight Disord 2020; 25:69-78. [PMID: 29726000 DOI: 10.1007/s40519-018-0506-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/15/2018] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE This study explored the relationship of illness perception with different aspects of cardiac anxiety, general anxiety and depression in a sample of male and female overweight and obese patients with cardiovascular diseases (CVD). STUDY DESIGN The clinical sample included 165 adults (113 males) aged from 32 to 89 years. The patients were admitted to the Department of Cardiology and Cardiac Rehabilitation for a major cardiovascular event, acute myocardial infarction or myocardial revascularization. MEASUREMENTS Psychological measurement included questionnaires of illness perception, cardiac anxiety, general anxiety and depression. RESULTS AND CONCLUSIONS Illness perception and cardiac anxiety in patients with CVD were associated with anxiety and depression. Regression analysis showed that illness perception accounts for a significant proportion of the variance in both anxiety and depression for males, but not for females. Gender-specific interrelations between perceptions of CVD and indices of mental health have an implication for interventions to maximize the effect of therapy with these patients. LEVEL OF EVIDENCE Level V, Descriptive study.
Collapse
|
12
|
Ryan I. Anxious Generation: a Review of the Relationship Between Anxiety Disorders and Cardiovascular Disease in Youth. CURR EPIDEMIOL REP 2020. [DOI: 10.1007/s40471-020-00228-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Zubcevic J, Richards EM, Yang T, Kim S, Sumners C, Pepine CJ, Raizada MK. Impaired Autonomic Nervous System-Microbiome Circuit in Hypertension. Circ Res 2019; 125:104-116. [PMID: 31219753 PMCID: PMC6588177 DOI: 10.1161/circresaha.119.313965] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hypertension affects an estimated 103 million Americans, yet gaps in knowledge continue to limit its successful management. Rapidly emerging evidence is linking gut dysbiosis to many disorders and diseases including hypertension. The evolution of the -omics techniques has allowed determination of the abundance and potential function of gut bacterial species by next-generation bacterial sequencing, whereas metabolomics techniques report shifts in bacterial metabolites in the systemic circulation of hypertensive patients and rodent models of hypertension. The gut microbiome and host have evolved to exist in balance and cooperation, and there is extensive crosstalk between the 2 to maintain this balance, including during regulation of blood pressure. However, an understanding of the mechanisms of dysfunctional host-microbiome interactions in hypertension is still lacking. Here, we synthesize some of our recent data with published reports and present concepts and a rationale for our emerging hypothesis of a dysfunctional gut-brain axis in hypertension. Hopefully, this new information will improve the understanding of hypertension and help to address some of these knowledge gaps.
Collapse
Affiliation(s)
- Jasenka Zubcevic
- Department of Physiological Sciences, College of Veterinary Medicine; University of Florida, Gainesville FL32610
| | - Elaine M. Richards
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville FL32610
| | - Tao Yang
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville FL32610
| | - Seungbum Kim
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville FL32610
| | - Colin Sumners
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville FL32610
| | - Carl J Pepine
- Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville FL32610
| | - Mohan K Raizada
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville FL32610
| |
Collapse
|
14
|
Mumm JLM, Pyrkosch L, Plag J, Nagel P, Petzold MB, Bischoff S, Fehm L, Fydrich T, Ströhle A. Heart rate variability in patients with agoraphobia with or without panic disorder remains stable during CBT but increases following in-vivo exposure. J Anxiety Disord 2019; 64:16-23. [PMID: 30875662 DOI: 10.1016/j.janxdis.2019.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/15/2019] [Accepted: 03/03/2019] [Indexed: 11/29/2022]
Abstract
Patients with anxiety disorders have a lower heart rate variability (HRV) than healthy controls. Low HRV is associated with cardiovascular disease and dysfunction of the autonomic nervous system (ANS). The aim of the present study was to investigate if HRV in patients with agoraphobia with or without panic disorder can be influenced by cognitive behavioral therapy (CBT). 73 patients with agoraphobia with or without panic disorder were included in the study. Heart rate (HR) and HRV were recorded at rest before and after CBT and during in-vivo exposure. No changes in HR and HRV were observed throughout therapy. During in-vivo exposure HRV increased significantly and HR exhibited a tendency to decrease. Despite clinical improvement of anxiety symptoms, ANS activity at rest did not seem to be influenced by CBT. However, during in-vivo exposure, HRV changed significantly, indicating a higher parasympathetic activity at the end of exposure.
Collapse
Affiliation(s)
- Jennifer Lara Maria Mumm
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| | - Lena Pyrkosch
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| | - Jens Plag
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| | - Patrick Nagel
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Cardiology, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - Moritz Bruno Petzold
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| | - Sophie Bischoff
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| | - Lydia Fehm
- Zentrum für Psychotherapie, Institut für Psychologie, Humboldt-Universität zu Berlin, Klosterstr. 64, 10179 Berlin, Germany.
| | - Thomas Fydrich
- Zentrum für Psychotherapie, Institut für Psychologie, Humboldt-Universität zu Berlin, Klosterstr. 64, 10179 Berlin, Germany.
| | - Andreas Ströhle
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| |
Collapse
|
15
|
Zuzarte P, Scola G, Duong A, Kostiw K, Figueira ML, Costa-Vitali A. NT-proBNP is a potential mediator between reduced ejection fraction and depression in patients with heart failure. J Psychiatr Res 2018; 104:8-15. [PMID: 29913350 DOI: 10.1016/j.jpsychires.2018.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/26/2018] [Accepted: 06/08/2018] [Indexed: 01/08/2023]
Abstract
Depression and anxiety are prevalent in patients with heart failure (HF). Reduced ejection fraction (EF) and increased N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) have been shown to be independently associated with depressive symptoms and may therefore increase HF disease progression and mortality. This study evaluated whether NT-proBNP mediated the impact of reduced EF on depressive and anxiety symptoms in patients with HF. Participants (n = 124) were patients with a diagnosis of chronic HF enrolled in the Heart Failure Disease Management Program at Health Sciences North. Subjects were assessed for depressive and anxiety symptoms according to the Hospital Anxiety and Depression Scale questionnaire at enrolment. Ejection fraction, measured through Multigated Acquisition Technique and NT-proBNP, measured through chemiluminescent immunoassay, were obtained at baseline. Patient outcomes were monitored for 12-months after enrollment. Associations were determined using regression and multivariate models. Indirect effects were assessed using mediation analysis. EF and NT-proBNP were highly correlated. Mediation analysis showed no significant direct effect of EF on the levels of depressive and anxiety symptoms, however, there was a significant indirect effect of EF on depression that was mediated by the levels of NT-proBNP, but not for EF and anxiety. Our results suggest that NT-proBNP is a potential mechanism linking reduced EF and depressive symptoms in patients with HF. While results are still preliminary, this study suggests that NT-proBNP may be a potential biomarker in identifying HF patients with reduced EF at high risk for depression, disease progression and mortality.
Collapse
Affiliation(s)
- Pedro Zuzarte
- Heart Failure Disease Management Program, Health Sciences North, Sudbury, Ontario, Canada; University of Lisbon, Faculty of Medicine, Lisbon, Portugal.
| | | | | | | | | | - Atilio Costa-Vitali
- Heart Failure Disease Management Program, Health Sciences North, Sudbury, Ontario, Canada; Cardiovascular CRO, Sudbury, ON, Canada
| |
Collapse
|
16
|
Jacob L, Haro JM, Koyanagi A. Post-traumatic stress symptoms are associated with physical multimorbidity: Findings from the Adult Psychiatric Morbidity Survey 2007. J Affect Disord 2018. [PMID: 29522958 DOI: 10.1016/j.jad.2018.02.063] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Studies on the association between symptoms of post-traumatic stress disorder (PTSD) and physical multimorbidity (i.e., ≥2 chronic conditions) are lacking. Thus, we assessed the association between PTSD symptoms and physical multimorbidity using nationally representative, community-based data of the UK adult population. METHODS Data from the 2007 Adult Psychiatric Morbidity Survey were analyzed. PTSD symptoms were assessed using the 10-item Trauma Screening Questionnaire (TSQ). A total score of ≥6 points indicated a probable PTSD. Information was collected on 20 doctor/other health professional diagnosed physical health conditions that were present in the past 12 months. Multimorbidity was defined as ≥2 physical diseases. Multivariable logistic regression and mediation analyses were conducted to analyze the association between PTSD and physical multimorbidity, and the influence of behavioral and psychological factors in this association. RESULTS Among 7403 individuals aged ≥16 years [mean age (SD) = 46.3 (18.6) years; 51.5% females], the prevalence of PTSD increased from 2.1% in individuals with no physical conditions to 5.4% in those with ≥4 physical conditions. After adjustment for sociodemographic factors and lifetime occurrence of a traumatic event, PTSD was associated with higher odds for physical multimorbidity (Odds Ratio [OR] = 2.47; 95% Confidence Interval [CI]: 1.71-3.56). Anxiety, depression, and disordered eating explained 35%, 21%, and 8% of the PTSD-multimorbidity association, respectively. LIMITATIONS Causality or temporal associations cannot be established due to the cross-sectional nature of the study. In addition, PTSD and physical conditions were assessed using self-reports. CONCLUSIONS PTSD symptoms may be risk factors for physical multimorbidity. Anxiety and depressive symptoms might play an important role in this association. Screening for chronic physical conditions among individuals with PTSD and treating them simultaneously may lead to better clinical outcomes.
Collapse
Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, 15 rue de l'École de Médecine, Paris 75006, France.
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| |
Collapse
|
17
|
Pratt R, Stapelberg NJC. Early warning biomarkers in major depressive disorder: a strategic approach to a testing question. Biomarkers 2018; 23:563-572. [DOI: 10.1080/1354750x.2018.1463563] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- R. Pratt
- Consultation Liaison Psychiatry, Nepean Hospital, Penrith, Australia
| | - N. J. C. Stapelberg
- Faculty of Health Sciences and Medicine, Bond University and Gold Coast Hospital and Health Service, Southport, Australia
| |
Collapse
|
18
|
Morrison I. Keep Calm and Cuddle on: Social Touch as a Stress Buffer. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2016. [DOI: 10.1007/s40750-016-0052-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|