LaGrange College, LaGrange, Georgia, USA.
Am J Cardiol. 2010 Jun 15;105(12):1661-5. doi: 10.1016/j.amjcard.2010.01.340.
Vital exhaustion, defined as excessive fatigue, feelings of demoralization, and increased irritability, has been identified as a risk factor for incident and recurrent cardiac events, but there are no population-based prospective studies of this association in US samples. We examined the predictive value of vital exhaustion for incident myocardial infarction or fatal coronary heart disease in middle-aged men and women in 4 US communities. Participants were 12,895 black or white men and women enrolled in the Atherosclerosis Risk In Communities (ARIC) study cohort and followed for the occurrence of cardiac morbidity and mortality from 1990 through 2002 (maximum follow-up 13.0 years). Vital exhaustion was assessed using the 21-item Maastricht Questionnaire and scores were partitioned into approximate quartiles for statistical analyses. High vital exhaustion (fourth quartile) predicted adverse cardiac events in age-, gender-, and race-center-adjusted analyses (1.69, 95% confidence interval 1.40 to 2.05) and in analyses further adjusted for educational level, body mass index, plasma low-density lipoprotein and high-density lipoprotein cholesterol levels, systolic and diastolic blood pressure levels, diabetes mellitus, cigarette smoking status, and pack-years of cigarette smoking (1.46, 95% confidence interval 1.20 to 1.79). Risk for adverse cardiac events increased monotonically from the first through the fourth quartile of vital exhaustion. Probabilities of adverse cardiac events over time were significantly higher in people with high vital exhaustion compared to those with low exhaustion (p = 0.002). In conclusion, vital exhaustion predicts long-term risk for adverse cardiac events in men and women, independent of established biomedical risk factors.
活力耗竭，定义为过度疲劳、道德败坏感和易怒，已被确定为发生和复发性心脏事件的一个风险因素，但在美国人群中，没有基于人群的前瞻性研究来探讨这种关联。我们研究了活力耗竭对 4 个美国社区中年男性和女性发生心肌梗死或致命性冠心病的预测价值。参与者为参加动脉粥样硬化风险社区（ARIC）研究队列的 12895 名黑人和白人男性和女性，从 1990 年到 2002 年（最长随访时间为 13.0 年）随访心脏发病率和死亡率。采用 21 项马斯特里赫特问卷评估活力耗竭，评分分为近似四分位数进行统计分析。高活力耗竭（第四四分位数）预测年龄、性别和种族中心调整分析中的不良心脏事件（1.69，95%置信区间 1.40 至 2.05），以及进一步调整教育水平、体重指数、血浆低密度脂蛋白和高密度脂蛋白胆固醇水平、收缩压和舒张压、糖尿病、吸烟状况和吸烟包年数的分析（1.46，95%置信区间 1.20 至 1.79）。从活力耗竭的第一四分位数到第四四分位数，不良心脏事件的风险呈单调递增。与低活力耗竭者相比，高活力耗竭者发生不良心脏事件的概率随时间显著增加（p = 0.002）。总之，活力耗竭独立于既定的生物医学危险因素预测男性和女性长期不良心脏事件的风险。
