Differences in Quality of Life, Anxiety and Depression in Patients with Paroxysmal Atrial Fibrillation and Common Forms of Atrioventricular Reentry Supraventricular Tachycardias

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Abstract

Introduction

The aim of this study was to evaluate the differences in quality of life and psychosocial stress parameters among patients with paroxysmal atrial fibrillation (AF) and common forms of atrioventricular reentry supraventricular tachycardias (SVTs).

Methods and Results

The total study population included 106 patients, 54 patients with paroxysmal AF (32 males, age 56.64±12.50 years) and 52 with SVTs (25 males, age 40.46±14.96 years). General health (p<0.01), physical function (p=0.004), role emotion (p=0.002) and role physical (p<0.01) scores were lower in patients who suffered AF. SF-36 physical and mental health summary measures were also significantly lower in the AF group compared to those in SVT group (p<0.01 and p=0.001, respectively). Lower SF-36 total score was observed in patients with AF compared to those with SVTs (p<0.01). Comparing the anxiety and depression scores all the values were higher in patients with AF. Higher STAI-state scores (p<0.01), STAI-trait scores (p=0.039) and BDI scores (p=0.077) were seen in patients who suffered AF comparing to those with SVTs.

Conclusions

Quality of life is significantly impaired and the level of anxiety is significantly higher in patients with AF comparing to those with common forms of SVTs.

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Most cited references 27

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The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups.

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The widespread use of standardized health surveys is predicated on the largely untested assumption that scales constructed from those surveys will satisfy minimum psychometric requirements across diverse population groups. Data from the Medical Outcomes Study (MOS) were used to evaluate data completeness and quality, test scaling assumptions, and estimate internal-consistency reliability for the eight scales constructed from the MOS SF-36 Health Survey. Analyses were conducted among 3,445 patients and were replicated across 24 subgroups differing in sociodemographic characteristics, diagnosis, and disease severity. For each scale, item-completion rates were high across all groups (88% to 95%), but tended to be somewhat lower among the elderly, those with less than a high school education, and those in poverty. On average, surveys were complete enough to compute scales scores for more than 96% of the sample. Across patient groups, all scales passed tests for item-internal consistency (97% passed) and item-discriminant validity (92% passed). Reliability coefficients ranged from a low of 0.65 to a high of 0.94 across scales (median = 0.85) and varied somewhat across patient subgroups. Floor effects were negligible except for the two role disability scales. Noteworthy ceiling effects were observed for both role disability scales and the social functioning scale. These findings support the use of the SF-36 survey across the diverse populations studied and identify population groups in which use of standardized health status measures may or may not be problematic.

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Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk.

Sheldon Cohen, Denise Janicki-Deverts, William Doyle … (2012)

We propose a model wherein chronic stress results in glucocorticoid receptor resistance (GCR) that, in turn, results in failure to down-regulate inflammatory response. Here we test the model in two viral-challenge studies. In study 1, we assessed stressful life events, GCR, and control variables including baseline antibody to the challenge virus, age, body mass index (BMI), season, race, sex, education, and virus type in 276 healthy adult volunteers. The volunteers were subsequently quarantined, exposed to one of two rhinoviruses, and followed for 5 d with nasal washes for viral isolation and assessment of signs/symptoms of a common cold. In study 2, we assessed the same control variables and GCR in 79 subjects who were subsequently exposed to a rhinovirus and monitored at baseline and for 5 d after viral challenge for the production of local (in nasal secretions) proinflammatory cytokines (IL-1β, TNF-α, and IL-6). Study 1: After covarying the control variables, those with recent exposure to a long-term threatening stressful experience demonstrated GCR; and those with GCR were at higher risk of subsequently developing a cold. Study 2: With the same controls used in study 1, greater GCR predicted the production of more local proinflammatory cytokines among infected subjects. These data provide support for a model suggesting that prolonged stressors result in GCR, which, in turn, interferes with appropriate regulation of inflammation. Because inflammation plays an important role in the onset and progression of a wide range of diseases, this model may have broad implications for understanding the role of stress in health.

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The effects of psychological stress on humans: increased production of pro-inflammatory cytokines and a Th1-like response in stress-induced anxiety.

M. Maes, I Benoy, Derek Smith … (1998)

There is some evidence that, in humans and experimental animals, psychological stress may suppress or enhance immune functions, depending on the nature of the stressor and the immune variables under consideration. The possibility that psychological stress may affect the production of pro-inflammatory and immunoregulatory cytokines was investigated in 38 medical students, who had blood samplings a few weeks before and after as well as one day before an academic examination. Psychological stress significantly increased the stimulated production of tumour necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), IL-1 receptor antagonist (IL-1Ra), interferon gamma (IFN-gamma) and IL-10. Students with high stress perception during the stressful condition had a significantly higher production of TNF-alpha, IL-6, IL-1Ra and IFN-gamma than students with a low-stress perception. Students with a high anxiety response had a significantly higher production of IFN-gamma and a lower production of the negative immunoregulatory cytokines, IL-10 and IL-4, than students without anxiety. These findings suggest that, in humans, changes in the production of the pro-inflammatory cytokines, TNF-alpha, IL-6 and IFN-gamma, and negative immunoregulatory cytokines, IL-10 and IL-4, take part in the homeostatic responses to psychological stress and that stress-induced anxiety is related to a T-helper-1-like response.

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Author and article information

Journal

Journal ID (nlm-ta): Indian Pacing Electrophysiol J

Journal ID (iso-abbrev): Indian Pacing Electrophysiol J

Journal ID (publisher-id): Indian Pacing Electrophysiol J

Title: Indian Pacing and Electrophysiology Journal

Publisher: Indian Heart Rhythm Society

ISSN (Electronic): 0972-6292

Publication date Collection: Sep-Oct 2014

Publication date (Electronic): 06 October 2014

Volume: 14

Issue: 5

Pages: 250-257

Affiliations

[1 ]Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Greece

[2 ]"Dromokaiteio" Psychiatric Hospital of Attica, Greece

[3 ]Department of Cardiology, University Hospital of Ioannina, Greece

[4 ]Department of Cardiology, "ELPIS" General Hospital of Athens, Greece

Author notes

Address for correspondence: Konstantinos P. Letsas, MD, FESC, Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, 10676, Athens, Greece. k.letsas@ 123456mail.gr

Article

Publisher ID: ipej140250-00

PMC ID: 4217297

PubMed ID: 25408565

SO-VID: bf81a0e6-f513-4d16-aae8-e662011f9cca

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Differences in Quality of Life, Anxiety and Depression in Patients with Paroxysmal Atrial Fibrillation and Common Forms of Atrioventricular Reentry Supraventricular Tachycardias

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Abstract

Introduction

Methods and Results

Conclusions

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Karger: Cardiovascular System

Most cited references 27

The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups.

Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk.

The effects of psychological stress on humans: increased production of pro-inflammatory cytokines and a Th1-like response in stress-induced anxiety.

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