Lane Richard D, Laukes Cindi, Marcus Frank I, Chesney Margaret A, Sechrest Lee, Gear Kathleen, Fort Carolyn L, Priori Silvia G, Schwartz Peter J, Steptoe Andrew
Department of Psychiatry, University of Arizona, Tucson, AZ 85724-5002, USA.
Psychosom Med. 2005 May-Jun;67(3):359-65. doi: 10.1097/01.psy.0000160476.67536.41.
Emotional stress is well established as a trigger of sudden death in the context of coronary heart disease (CHD), but its role in patients experiencing cardiac arrest with apparently normal hearts is unknown. This study sought to determine the role of psychosocial stress as a precipitant of cardiac arrest in patients with apparently normal hearts, so-called idiopathic ventricular fibrillation (IVF).
We interviewed 25 IVF survivors (12 men, 13 women) and 25 matched comparison patients regarding life events during the 6 months and 24 hours preceding the cardiac event. The comparison group consisted of patients with an acute myocardial infarction or angina pectoris requiring angioplasty but without cardiac arrest. Judges independently rated written summaries of these interviews for psychosocial stress at each time point on a three-point scale (low, moderate, severe).
During the 6 months before the cardiac event, 20 patients sustaining IVF had severe/moderate stress and five had low stress, whereas 10 comparison patients had severe/moderate stress and 15 had low stress (Fisher exact p = .008). During the preceding 24 hours, nine patients with IVF had severe/moderate stress and 16 had low stress, whereas two comparison patients had severe/moderate stress and 22 had low stress (Fisher exact p = .04) (one silent myocardial infarction could not be precisely dated).
These data suggest that psychosocial stress is playing a role in otherwise unexplained cardiac arrest.
在冠心病（CHD）背景下，情绪应激已被确认为猝死的诱因，但在心脏看似正常的心脏骤停患者中其作用尚不清楚。本研究旨在确定心理社会应激在心脏看似正常的患者（即所谓的特发性室颤[IVF]）心脏骤停中的诱发作用。
我们就心脏事件发生前6个月和24小时内的生活事件，对25名IVF幸存者（12名男性，13名女性）和25名匹配的对照患者进行了访谈。对照组由需要进行血管成形术但未发生心脏骤停的急性心肌梗死或心绞痛患者组成。评判者在每个时间点根据心理社会应激程度，对这些访谈的书面总结进行三点量表评分（低、中、高）。
在心脏事件发生前6个月，20名发生IVF的患者有重度/中度应激，5名有轻度应激，而10名对照患者有重度/中度应激，15名有轻度应激（Fisher精确检验p = 0.008）。在之前的24小时内，9名IVF患者有重度/中度应激，16名有轻度应激，而2名对照患者有重度/中度应激，22名有轻度应激（Fisher精确检验p = 0.04）（1例无症状心肌梗死无法精确确定时间）。
这些数据表明，心理社会应激在其他方面无法解释的心脏骤停中发挥了作用。
