Left Ventricular Ejection Fraction Predicts Severity of Post-traumatic Stress Disorder in Patients with Implantable Cardioverter-defibrillators.
Left Ventricular Ejection Fraction Predicts Severity of Post-traumatic Stress Disorder in Patients with Implantable Cardioverter-defibrillators.
复制标题
左心室射血分数可预测植入式心脏复律除颤器患者的创伤后应激障碍的严重程度。
DOI：
10.1002/clc.22521
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发表时间：
2015
影响因子：
2.7
通讯作者：
Chishaki A.
中科院分区：
文献类型：
--
作者：
9.Sawatari H;Ohkusa T;Anita Rahamawati;Ishikawa K;Tsuchihashi-Makaya M;Ohtsuka Y;Nakai M;Miyazono M;Hashiguchi N;Chishaki H;Sakurada H;Mukai Y;Inoue S;Sunagawa K;Chishaki A.
植入式心律转复除颤器（ICD）为致命性心律失常提供了有效的治疗方法。然而，众所周知，如果ICD患者经历过可能致命的心律失常和ICD电击，他们会出现心理问题，如创伤后应激障碍（PTSD）。对影响ICD患者PTSD的因素知之甚少。假设超声心动图心功能参数可能与ICD患者的心理问题有关，尤其是PTSD。方法对128例门诊ICD植入患者进行创伤后应激障碍（PTSD）事件影响量表（IES - R）测评。从医疗记录中收集人口统计学和临床特征数据。结果ICD患者平均年龄59±16岁；男性103例；超声心动图左室射血分数（LVEF）平均值为52.4%±18.3%。在ICD患者中，女性和LVEF受损与较低的IES - R评分或导致PTSD相关（P分别= 0.01和P= 0.03）。LVEF受损还加重了PTSD、干扰（P= 0.02）和过度觉醒（P= 0.03）的症状。在LVEF <35%的患者中，LVEF水平与IES - R评分呈显著负相关（P= 0.045）。结论LVEF与PTSD的严重程度有关，尤其是LVEF <35%的ICD患者。对于左心室功能严重受损的ICD患者应给予重视，防止出现心理问题。
BackgroundImplantable cardioverter‐defibrillators (ICD) have provided effective therapy for fatal arrhythmia. However, ICD patients are known to develop psychological problems, such as posttraumatic stress disorder (PTSD), if they have experienced potentially fatal arrhythmia and ICD shocks. Little is known about the factors influencing PTSD in ICD patients.HypothesisEchocardiographic cardiac‐function parameters might relate to psychological problems, especially PTSD, in ICD patients.MethodsA total of 128 outpatients with ICD implantation completed the Impact of Event Scale Revised (IES‐R) questionnaire as a measurement of PTSD. Demographic and clinical characteristic data were collected from medical records.ResultsThe mean age of the ICD patients was 59 ± 16 years; 103 were male; and the mean left ventricular ejection fraction (LVEF) by echocardiography was 52.4% ± 18.3%. In the ICD patients, female sex and impaired LVEF were related to lower IES‐R scores or led to PTSD (P= 0.01 andP= 0.03, respectively). Impaired LVEF also worsened 2 symptoms of PTSD, intrusion (P= 0.02) and hyperarousal (P= 0.03). In patients with LVEF <35%, there was a significant negative correlation between LVEF level and IES‐R score (P= 0.045).ConclusionsThis study showed that LVEF was related to the severity of PTSD, especially in the ICD patients with LVEF of <35%. We should pay more attention to ICD patients with severely impaired left ventricular function to prevent psychological problems.