Left Ventricular Ejection Fraction Predicts Severity of Posttraumatic Stress Disorder in Patients with Implantable Cardioverter-Defibrillators

Hiroyuki Sawatari, Tomoko Ohkusa, Anita Rahamawati, Katsuhiko Ishikawa, Miyuki Tsuchihashi-Makaya, Yuko Ohtsuka, Mori Nakai, Mami Miyazono, Nobuko Hashiguchi, Hiroaki Chishaki, Harumizu Sakurada, Yasushi Mukai, Shujiro Inoue, Kenji Sunagawa, Akiko Chishaki

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)263-268
Number of pages6
JournalClinical Cardiology
Volume39
Issue number5
DOIs
Publication statusPublished - May 1 2016

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Implantable Defibrillators
Post-Traumatic Stress Disorders
Stroke Volume
Psychology
Cardiac Arrhythmias
Left Ventricular Function
Medical Records
Echocardiography
Shock
Outpatients
Demography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Left Ventricular Ejection Fraction Predicts Severity of Posttraumatic Stress Disorder in Patients with Implantable Cardioverter-Defibrillators. / Sawatari, Hiroyuki; Ohkusa, Tomoko; Rahamawati, Anita; Ishikawa, Katsuhiko; Tsuchihashi-Makaya, Miyuki; Ohtsuka, Yuko; Nakai, Mori; Miyazono, Mami; Hashiguchi, Nobuko; Chishaki, Hiroaki; Sakurada, Harumizu; Mukai, Yasushi; Inoue, Shujiro; Sunagawa, Kenji; Chishaki, Akiko.

In: Clinical Cardiology, Vol. 39, No. 5, 01.05.2016, p. 263-268.

Research output: Contribution to journalArticle

Sawatari, H, Ohkusa, T, Rahamawati, A, Ishikawa, K, Tsuchihashi-Makaya, M, Ohtsuka, Y, Nakai, M, Miyazono, M, Hashiguchi, N, Chishaki, H, Sakurada, H, Mukai, Y, Inoue, S, Sunagawa, K & Chishaki, A 2016, 'Left Ventricular Ejection Fraction Predicts Severity of Posttraumatic Stress Disorder in Patients with Implantable Cardioverter-Defibrillators', Clinical Cardiology, vol. 39, no. 5, pp. 263-268. https://doi.org/10.1002/clc.22521
Sawatari, Hiroyuki ; Ohkusa, Tomoko ; Rahamawati, Anita ; Ishikawa, Katsuhiko ; Tsuchihashi-Makaya, Miyuki ; Ohtsuka, Yuko ; Nakai, Mori ; Miyazono, Mami ; Hashiguchi, Nobuko ; Chishaki, Hiroaki ; Sakurada, Harumizu ; Mukai, Yasushi ; Inoue, Shujiro ; Sunagawa, Kenji ; Chishaki, Akiko. / Left Ventricular Ejection Fraction Predicts Severity of Posttraumatic Stress Disorder in Patients with Implantable Cardioverter-Defibrillators. In: Clinical Cardiology. 2016 ; Vol. 39, No. 5. pp. 263-268.
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abstract = "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.",
author = "Hiroyuki Sawatari and Tomoko Ohkusa and Anita Rahamawati and Katsuhiko Ishikawa and Miyuki Tsuchihashi-Makaya and Yuko Ohtsuka and Mori Nakai and Mami Miyazono and Nobuko Hashiguchi and Hiroaki Chishaki and Harumizu Sakurada and Yasushi Mukai and Shujiro Inoue and Kenji Sunagawa and Akiko Chishaki",
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T1 - Left Ventricular Ejection Fraction Predicts Severity of Posttraumatic Stress Disorder in Patients with Implantable Cardioverter-Defibrillators

AU - Sawatari, Hiroyuki

AU - Ohkusa, Tomoko

AU - Rahamawati, Anita

AU - Ishikawa, Katsuhiko

AU - Tsuchihashi-Makaya, Miyuki

AU - Ohtsuka, Yuko

AU - Nakai, Mori

AU - Miyazono, Mami

AU - Hashiguchi, Nobuko

AU - Chishaki, Hiroaki

AU - Sakurada, Harumizu

AU - Mukai, Yasushi

AU - Inoue, Shujiro

AU - Sunagawa, Kenji

AU - Chishaki, Akiko

PY - 2016/5/1

Y1 - 2016/5/1

N2 - 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.

AB - 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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