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.

Abstract. Introduction: In recent years, evidence has been accumulating that interpersonal violence (IV) in sports coaching situations has detrimental psychopathological effects. IV victimization not only produces traditional adverse symptoms, but also impairs psychological functioning related to self-evaluation and interpersonal relationships in personality development. We designed this study to explore the psychopathological damage caused by IV experiences in Japanese sports coaching situations from the perspective of PTSD and moral injury (MI). Methods: We conducted a Web-based aggregate survey using convenience sampling. Japanese university undergraduates ( N=196, age range 18-23 years) participated in the study. We used hierarchical multiple regression and simple slope analyses to examine quantitative data after controlling for covariates. Results: There was a significant main effect of experiencing psychological violence and MI on several PTSD symptoms, including intrusion, avoidance, and hyperarousal. In addition, a high frequency of experiencing psychological violence enhanced intrusion and hyperarousal symptoms only when causes MI. Conclusion: These results are consistent with previous studies that identified IV-related mental health harms. The result also indicate that the damage caused by IV in sports contexts is complex and aggravated by the deep intrinsic and moral emotional wounds. The primary findings of this study are crucial for protecting athlete’ human rights, further enhancing sports leadership education, and for proactive consideration of preventive intervention strategies.