Left Ventricular Ejection Fraction Predicts Severity of Posttraumatic Stress Disorder in Patients With Implantable
Hiroyuki Sawatari1, Tomoko Ohkusa2, Anita Rahamawati3
1Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Insights
Implantable cardioverter-defibrillator patients with impaired left ventricular ejection fraction (LVEF) may experience worse post-traumatic stress disorder (PTSD) symptoms. Lower LVEF is linked to increased PTSD severity, particularly in those with LVEF below 35%.
Area of Science:
- Cardiology
- Psychology
- Medical Devices
Background:
- Implantable cardioverter-defibrillators (ICDs) treat fatal arrhythmias but can lead to psychological distress, including post-traumatic stress disorder (PTSD), especially after experiencing shocks.
- Factors influencing PTSD development in ICD patients remain underexplored.
Purpose of the Study:
- To investigate the relationship between echocardiographic cardiac function parameters and psychological problems, specifically PTSD, in patients with ICDs.
Main Methods:
- 128 outpatients with ICDs completed the Impact of Event Scale Revised (IES-R) questionnaire to assess PTSD.
- Demographic and clinical data, including left ventricular ejection fraction (LVEF), were collected from medical records.
Main Results:
- Female sex and impaired LVEF were associated with lower IES-R scores (indicating less PTSD) or the development of PTSD (P=0.01 and P=0.03).
- Impaired LVEF significantly worsened PTSD symptoms of intrusion (P=0.02) and hyperarousal (P=0.03).
- A negative correlation between LVEF and IES-R scores was observed in patients with LVEF <35% (P=0.045).
Conclusions:
- Left ventricular ejection fraction (LVEF) is related to PTSD severity in ICD patients, particularly those with LVEF <35%.
- Increased attention should be directed towards ICD patients with severely impaired left ventricular function to proactively manage psychological well-being.
Background:
Implantable 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.
Hypothesis:
Echocardiographic cardiac-function parameters might relate to psychological problems, especially PTSD, in ICD patients.
Methods:
A 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.
Results:
The 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 and P = 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).
Conclusions:
This 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.
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