Perceived Social Support, Heart Rate Variability, and Hopelessness in Patients with Ischemic Heart Disease

缺血性心脏病患者的社会支持感、心率变异性和绝望感

• 批准号: 10312875
• 负责人: Madison P Goodyke
• 金额: $ 4.6万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-16 至 2023-07-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10312875
• 关键词: Acute; Address; Adverse effects; Adverse event; American Heart Association; Area; Biological; Biological Markers; Bluetooth; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Characteristics; Chicago; Cross-Sectional Studies; Data; Data Collection; Development; Enrollment; Environment; Equipment and supply inventories; Event; Evidence based intervention; Feeling; Feeling hopeless; Foundations; Frequencies; Functional disorder; Funding; Future; Goals; Health; Health Promotion; Heart; Heart Diseases; Heart Rate; Hospitals; Illinois; Impaired health; Individual; Intervention; Lead; Malignant Neoplasms; Measurement; Measures; Mediating; Mental Depression; Mental Health; Methods; Mission; Modeling; Morbidity - disease rate; Myocardial Infarction; Myocardial Ischemia; Outcome; Outcomes Research; Participant; Patients; Perception; Persons; Pilot Projects; Preparation; Prevention strategy; Public Health; Reaction; Recovery; Reporting; Research; Research Design; Research Personnel; Research Support; Research Training; Rest; Risk; Science; Secondary Prevention; Social support; Stress; Stressful Event; Symptoms; System; Techniques; Testing; Time; Training; United States National Institutes of Health; Universities; Vagus nerve structure; biological adaptation to stress; cardiovascular risk factor; disease diagnosis; experience; fighting; heart rate monitor; heart rate variability; improved; mortality; mortality risk; novel; personalized intervention; programs; psychologic; psychological distress; psychological outcomes; rate of change; recruit; response; social; social determinants; stress management; stressor; symptom science; theories; trait

Cardiovascular disease is the leading cause of death worldwide, with ischemic heart disease (IHD) the leading cause of cardiovascular mortality. Persons with IHD suffering from psychological distress, including hopelessness, are more likely to die from IHD. Following a stressful event, the vagus nerve enables activation of either a sympathetic (fight/flight) or parasympathetic (rest/digest) response. Heart rate variability (HRV), the beat-to-beat variability between normal successive heart beats, is a biomarker of both adaptive and maladaptive reactions to stress. Decreased HRV predicts greater risk for morbidity and mortality and is associated with poor mental health outcomes in persons with IHD. As stated by polyvagal theory, HRV may be influenced by social support. Decreased perceived social support (PSS), a social determinant of cardiovascular risk, is predictive of increased morbidity and mortality in persons with IHD. Decreased PSS has been associated with hopelessness in patients with cancer, but this relationship has not been studied in IHD beyond the applicant’s small pilot study of patients with hopelessness. Hopelessness, a negative outlook and sense of helplessness about the future, is present in 27-52% of patients with IHD. This is of grave concern, because hopelessness is associated with a 3.4 times increased risk of mortality and nonfatal myocardial infarction in patients with IHD, independent of depression. This research focuses on understanding the biological (HRV) and social (PSS) aspects of hopelessness, with the long-term goal of developing and testing novel interventions to reduce the adverse effects of hopelessness and improve health outcomes in patients with IHD. Participants for this cross-sectional study will be recruited while hospitalized for an IHD event. Participants will include patients who report moderate to severe hopelessness from the sponsor’s NIH-funded study (n = 225); additional patients with minimal to no hopelessness will be recruited and enrolled by the applicant (n = 45). Data collection will take place remotely two weeks after hospital discharge. The applicant’s training goals are focused on a strong foundation in IHD pathophysiology; HRV science and measurement; research design, methods, conduct, and analytical techniques; and team science. The research training will take place in the rich scientific environment at the University of Illinois Chicago. Specific aims include: Aim 1) Evaluate the relationship between HRV and hopelessness in patients with IHD; Aim 2) Determine the relationship between PSS and hopelessness in patients with IHD; and Aim 3) Explore the possible mediating effect of HRV on the relationship between PSS and hopelessness in patients with IHD. The outcomes of this proposed study and the training plan will prepare the applicant to launch a program of research focused on the biological and social dynamics of symptoms experienced in patients with IHD. The proposed research supports NINR’s mission by addressing an important issue within the area of Symptom Science: Promoting Personalized Health Strategies with a long-term goal of promoting personalized health treatments for persons with IHD.

心血管疾病是世界范围内的主要死亡原因，其中缺血性心脏病（IHD）是最常见的死亡原因。 心血管疾病死亡的主要原因。患有IHD的人遭受心理困扰，包括 更有可能死于IHD。在压力事件之后，迷走神经激活 交感神经（战斗/逃跑）或副交感神经（休息/消化）反应。心率变异性（HRV）， 正常连续心跳之间的心跳间变异性是适应性和 对压力的适应不良反应心率变异性降低预示着发病率和死亡率的风险增加， 与IHD患者的不良心理健康结果相关。如多迷走神经理论所述，HRV可能是 受社会支持的影响。感知社会支持（PSS）减少，这是心血管疾病的社会决定因素 风险，是预测增加发病率和死亡率的人与IHD。PSS下降， 与癌症患者的绝望有关，但这种关系尚未在IHD中进行研究， 申请人对绝望患者的小型试点研究。绝望，消极的前景和感觉 27 - 52%的IHD患者对未来感到无助。这是一个严重的问题，因为 绝望与死亡率和非致命性心肌梗死的风险增加3.4倍相关， 与抑郁症无关的IHD患者。这项研究的重点是了解生物（HRV） 和社会（PSS）方面的绝望，与开发和测试新的长期目标， 干预措施，以减少绝望的不良影响，改善IHD患者的健康结果。 本横断面研究的受试者将在因IHD事件住院期间招募。参与者将 包括来自申办者NIH资助的研究的报告中度至重度绝望的患者（n = 225）; 申请人将招募和登记具有最小至没有绝望的额外患者（n = 45）。 数据收集将在出院后两周远程进行。申请人的培训目标是 专注于IHD病理生理学的坚实基础; HRV科学和测量;研究设计， 方法，行为和分析技术;和团队科学。研究培训将在 伊利诺伊大学芝加哥丰富的科学环境。具体目标包括：目标1）评估 IHD患者HRV与绝望感的关系;目的2）确定 IHD患者的PSS和绝望感;目的3）探讨HRV在IHD患者PSS和绝望感中的可能中介作用。 缺血性心脏病患者PSS与无望感的关系这项研究的结果和 培训计划将准备申请人启动一个研究计划，重点是生物和社会 IHD患者经历的症状动力学。拟议的研究支持NINR的使命， 解决症状科学领域的一个重要问题：促进个性化健康策略 其长期目标是促进IHD患者的个性化健康治疗。