Psychological factors and cardiac repolarization instability during anger in implantable cardioverter defibrillator patients.
Psychological factors and cardiac repolarization instability during anger in implantable cardioverter defibrillator patients.
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DOI：
10.1111/anec.12848
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Kop WJ
中科院分区：
文献类型：
--
作者：
Krantz DS;Harris KM;Rogers HL;Whittaker KS;Haigney MCP;Kop WJ
有证据表明，愤怒等情绪与心源性猝死的发生率增加有关，但其生物学机制仍不清楚。我们检验了这样一个假设，即在猝死易感性患者中，愤怒与心脏复极不稳定性指数相关。患有冠状动脉疾病（CAD）和植入式心律转复除颤器（ICD; n = 41）的患者和健康对照组（n = 26）进行了愤怒诱导演讲（愤怒回忆），评定了他们当前（状态）的愤怒，并完成了愤怒和敌意的特质（慢性）水平的测量。使用QT变异指数（QTVI）在静息基线和愤怒回忆期间使用连续ECG测量复极不稳定性。与对照组相比，ICD患者在基线和愤怒回忆期间的QTVI显著更高，表明总体上更大的情绪脆弱性。QTVI从基线到愤怒回忆的增加在两组中的程度相似。在ICD患者而非对照组中，在愤怒回忆期间，自我评定的愤怒与QTVI相关（r = .44，p = .007）。特质（慢性）愤怒表达（r = 0.26，p = 0.04）、愤怒控制（r =-0.26，p = 0.04）和敌意（r = 0.25，p = 0.05）分别与QTVI从基线到愤怒回忆的变化（ΔQTVI）相关。适度分析评估了心理特质与ΔQTVI的关联是否仅限于ICD组。结果表明，在ICD患者中，敌意评分可预测从基线到愤怒回忆的ΔQTVI（β = 0.07，p = 0.01），但在对照组中则不然。愤怒增加复极不稳定性，但在CAD和心肌脆弱性患者中，慢性和急性愤怒相互作用，触发与恶性心律失常易感性相关的心脏复极不稳定性。
Evidence indicates that emotions such as anger are associated with increased incidence of sudden cardiac death, but the biological mechanisms remain unclear. We tested the hypothesis that, in patients with sudden death vulnerability, anger would be associated with arrhythmic vulnerability, indexed by cardiac repolarization instability. Patients with coronary artery disease (CAD) and an implantable cardioverter defibrillator (ICD; n = 41) and healthy controls (n = 26) gave an anger‐inducing speech (anger recall), rated their current (state) anger, and completed measures of trait (chronic) levels of Anger and Hostility. Repolarization instability was measured using QT Variability Index (QTVI) at resting baseline and during anger recall using continuous ECG. ICD patients had significantly higher QTVI at baseline and during anger recall compared with controls, indicating greater arrhythmic vulnerability overall. QTVI increased from baseline to anger recall to a similar extent in both groups. In ICD patients but not controls, during anger recall, self‐rated anger was related to QTVI (r = .44, p = .007). Trait (chronic) Anger Expression (r = .26, p = .04), Anger Control (r = −.26, p = .04), and Hostility (r = .25, p = .05) were each associated with the change in QTVI from baseline to anger recall (ΔQTVI). Moderation analyses evaluated whether psychological trait associations with ΔQTVI were specific to the ICD group. Results indicated that Hostility scores predicted ΔQTVI from baseline to anger recall in ICD patients (β = 0.07, p = .01), but not in controls. Anger increases repolarization lability, but in patients with CAD and arrhythmic vulnerability, chronic and acute anger interact to trigger cardiac repolarization lability associated with susceptibility to malignant arrhythmias.
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影响因子：
24
作者：
Haigney, MC;Zareba, W;Moss, AJ
通讯作者：
Moss, AJ
影响因子：
3.3
作者：
Burg, MM;Lampert, R;Jain, D
通讯作者：
Jain, D
影响因子：
2.8
作者：
Akinboboye, O;Krantz, DS;Gottdiener, JS
通讯作者：
Gottdiener, JS
DOI：
10.1111/j.1540-8167.1998.tb00130.x
发表时间：
1998-09-01
影响因子：
2.7
作者：
Atiga, WL;Calkins, H;Berger, RD
通讯作者：
Berger, RD
DOI：
10.1016/0735-1097(95)00510-2
发表时间：
1996-03-01
影响因子：
24
作者：
Gabbay, FH;Krantz, DS;Rozanski, A
通讯作者：
Rozanski, A