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Published on: June 12, 2021
Social support predicts hemodynamic recovery from mental stress in patients with implanted defibrillators
Bernhard Lache1, Thomas Meyer, Christoph Herrmann-Lingen
1Department of Psychosomatics and Psychotherapy, Georg-August University, Göttingen, Göttingen, Germany.
Insights
Social support aids cardiovascular recovery in patients with implanted cardioverter-defibrillators (ICD) after mental stress. Higher perceived social support predicts better hemodynamic recovery, crucial for managing heart conditions.
Area of Science:
- Cardiology
- Psychosocial Medicine
- Autonomic Neuroscience
Background:
- Psychological stress is linked to arrhythmias and myocardial infarction in cardiac patients.
- The physiological mechanisms connecting stress to adverse cardiac events are not fully understood.
- Implanted cardioverter-defibrillators (ICD) offer a platform to study stress responses in high-risk patients.
Purpose of the Study:
- To investigate the impact of emotions and social support on cardiovascular recovery from mental stress in ICD patients.
- To test the hypothesis that psychosocial resources promote adaptive hemodynamic responses to stress.
- To identify predictors of hemodynamic recovery following mental stress in cardiac patients.
Main Methods:
- 55 ICD patients underwent noninvasive hemodynamic and autonomic monitoring during two mental stress tests (arithmetic, anger recall).
- Psychometric self-rating tests assessed anxiety, depression (HADS), anger (STAXI), and perceived social support (FSozU).
- Cardiovascular data were correlated with psychosocial factors to identify recovery predictors.
Main Results:
- 82% of participants exhibited rapid hemodynamic recovery (decreased cardiac index, blood pressure, heart rate; increased heart rate variability) post-stress.
- Patients lacking hemodynamic recovery reported significantly lower social support.
- Social support independently predicted preserved hemodynamic recovery (OR 4.1, P=.015), even after adjusting for confounders.
Conclusions:
- Enhanced perceived social support is associated with more robust hemodynamic recovery after mental stress in ICD patients.
- Social support may serve as a protective factor against adverse cardiovascular responses to psychological stress.
- These findings highlight the importance of psychosocial interventions in managing cardiac patients.
Objective:
Emotionally stressful events appear to trigger malignant ventricular arrhythmias and myocardial infarction in cardiac patients. However, the physiological pathways linking psychological stress to arrhythmias and adverse disease outcomes remain incompletely understood. In patients with implanted cardioverter-defibrillators (ICD) we investigated the impact of emotions and social support on cardiovascular recovery from mental stress. The hypothesis tested was that psychosocial resources help to maintain adaptive hemodynamic responses to mental stress.
Methods:
In 55 ICD patients we noninvasively measured hemodynamic and autonomic parameters during two sequentially performed mental stress tests (arithmetic and anger recall tests). The cardiovascular data obtained were associated with results from well-validated psychometric self-rating tests for anxiety and depression (HADS), anger (STAXI), and perceived social support (FSozU).
Results:
In the rest period after mental stress application the majority of the study participants (82%) showed a rapid fall in cardiac index, arterial blood pressure, and heart rate, as well as an increase in high-frequency heart rate variability, while the remainder had no or unexpected changes in the hemodynamic parameters examined. Patients missing hemodynamic recovery in the post-stress phase reported significantly less social support than normally reacting patients (P<.05). Multivariate logistic regression models confirm that social support is an independent and significant predictor of preserved hemodynamic recovery from mental stress, even after controlling for somatic confounders (multivariate odds ratio 4.1; 95% confidence interval 1.3-12.7; P=.015).
Conclusions:
Our data indicate that in ICD patients better perceived social support is associated with a more pronounced hemodynamic recovery after mental stress.
