Prognostic significance of ventricular arrhythmia modified by ability to adapt to stressful situations

André-Petersson, Lena; Engström, Gunnar; Hedblad, Bo; Janzon, Lars; Steen, Göran O.; Tydén, Patrik

doi:10.1097/01.hjr.0000116826.84388.30

Cited by 8 publications

(4 citation statements)

References 39 publications

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“…An association between sAA activity and autonomic cardiovascular parameters has been reported in healthy subjects in response to physical as well as psychological stressors 13. Furthermore, exercise,24 and smoking,25 as well as psychological factors known to stimulate sAA activity such as anger,26 anxiety, phobic anxiety27 and maladaptive behaviour in stressful encounters,28 have been shown to be associated with the risk of VA or SCD, providing a theoretical basis for the use of the sAA assay.…”

Section: Discussionmentioning

confidence: 98%

Initial salivary -amylase activity predicts malignant ventricular arrhythmias and short-term prognosis after ST-segment elevation myocardial infarction

Shen

Chan

Chen

et al. 2011

Emergency Medicine Journal

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Section: Discussionmentioning

confidence: 98%

Initial salivary -amylase activity predicts malignant ventricular arrhythmias and short-term prognosis after ST-segment elevation myocardial infarction

Shen

Chan

Chen

et al. 2011

Emergency Medicine Journal

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“…For instance, it may modify the effect of risk factors. A recent study showed that the effect of ventricular arrhythmia on prognosis was absent in those with good ability for tension regulation [48]. We need new studies not only to replicate the result and estimate effect size more accurately, but also to obtain information on the possible pathways of such an effect.…”

Section: Discussionmentioning

confidence: 99%

Relaxation therapy for rehabilitation and prevention in ischaemic heart disease: a systematic review and meta-analysis

Dixhoorn

White

2005

European Journal of Cardiovascular Prevention & Rehabilitat

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Aims To establish the effects of relaxation therapy on the recovery from a cardiac ischaemic event and secondary prevention. Methods and results A search was conducted for controlled trials in which patients with myocardial ischaemia were taught relaxation therapy, and outcomes were measured with respect to physiological, psychological, cardiac effects, return to work and cardiac events. A total of 27 studies were located. Six studies used abbreviated relaxation therapy (3 h or less of instruction), 13 studies used full relaxation therapy (9 h of supervised instruction and discussion), and in eight studies full relaxation therapy was expanded with cognitive therapy (11 h on average). Physiological outcomes: reduction in resting heart rate, increased heart rate variability, improved exercise tolerance and increased high-density lipoprotein cholesterol were found. No effect was found on blood pressure or cholesterol. Psychological outcome: state anxiety was reduced, trait anxiety was not, depression was reduced. Cardiac effects: the frequency of occurrence of angina pectoris was reduced, the occurrence of arrhythmia and exercise induced ischaemia were reduced. Return to work was improved. Cardiac events occurred less frequently, as well as cardiac deaths. With the exception of resting heart rate, the effects were small, absent or not measured in studies in which abbreviated relaxation therapy was given. No difference was found between the effects of full or expanded relaxation therapy. Conclusion Intensive supervised relaxation practice enhances recovery from an ischaemic cardiac event and contributes to secondary prevention. It is an important ingredient of cardiac rehabilitation, in addition to exercise and psychoeducation.

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“…Behaviors categorized as adaptive show stable or increasing time consumption throughout the test but do not show recurrent declines and increases in time consumption. The Variability-dimension was chosen for the present study because its associations with increased incidence of MI in men [ 10 , 12 , 13 ]. All categorization of behavior in this study is based on comparisons of test scores with reference-medians obtained from the 180 patients that were able to participate in the CWT in the SECAMI-study.…”

Section: Methodsmentioning

confidence: 99%

“…Hypertensive men who many years in advance of a clinical event had difficulties to adapt to the stressful test were exposed to an increased risk of a myocardial infarction (MI) [ 10 ] or stroke [ 11 ]. Ventricular arrhythmia [ 12 ] and asymptomatic atherosclerosis [ 13 ] were less important predictors among the men who managed to handle the stressful task in an adaptive manner. Postinfarction mortality within 28 days and within one year could also be explained by behavior in the serial CWT [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Behavior in a stressful situation, personality factors, and disease severity in patients with acute myocardial infarction: baseline findings from the prospective cohort study SECAMI (The Secondary Prevention and Compliance following Acute Myocardial Infarction-study)

André-Petersson

Schlyter

Engström

et al. 2011

BMC Cardiovasc Disord

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BackgroundPsychosocial stress has been identified as a risk factor in association with cardiovascular disease but less attention has been paid to heterogeneity in vulnerability to stress. The serial Color Word Test (CWT) measures adaptation to a stressful situation and it can be used to identify individuals that are vulnerable to stress. Prospective studies have shown that individuals with a maladaptive behavior in this test are exposed to an increased risk of future cardiovascular events. The aim of the present study was to investigate whether maladaptive behavior in the serial CWT alone or in combination with any specific personality dimension was associated with severity of myocardial infarction (MI).MethodsMI-patients (n = 147) completed the test and filled in a personality questionnaire in close proximity to the acute event. The results were analyzed in association with four indicators of severity: maximum levels above median of the cardiac biomarkers troponin I and creatine kinase-MB (CKMB), Q-wave infarctions, and a left ventricular ejection fraction (LVEF) ≤ 50%.ResultsMaladaptive behavior in the serial CWT together with low scores on extraversion were associated with maximum levels above median of cardiac troponin I (OR 2.97, CI 1.08-8.20, p = 0.04) and CKMB (OR 3.33, CI 1.12-9.93, p = 0.03). No associations were found between the combination maladaptive behavior and low scores on extraversion and Q-wave infarctions or a decreased LVEF.ConclusionsMaladaptive behavior in combination with low scores on extraversion is associated with higher cardiac biomarker levels following an MI. The serial CWT and personality questionnaires could be used to identify individuals vulnerable to the hazardous effects of stress and thereby are exposed to an increased risk of a more severe infarction.

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Prognostic significance of ventricular arrhythmia modified by ability to adapt to stressful situations

Abstract: A maladaptive behaviour in a stressful encounter makes men with electrocardiographically detected ventricular arrhythmias more vulnerable and thereby exposed to an increased risk of a future myocardial infarction and overall mortality.

Cited by 8 publications

References 39 publications

Initial salivary -amylase activity predicts malignant ventricular arrhythmias and short-term prognosis after ST-segment elevation myocardial infarction

Initial salivary -amylase activity predicts malignant ventricular arrhythmias and short-term prognosis after ST-segment elevation myocardial infarction

Relaxation therapy for rehabilitation and prevention in ischaemic heart disease: a systematic review and meta-analysis

Behavior in a stressful situation, personality factors, and disease severity in patients with acute myocardial infarction: baseline findings from the prospective cohort study SECAMI (The Secondary Prevention and Compliance following Acute Myocardial Infarction-study)

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