Institute of Behavioural Sciences, Department of Psychology, University of Helsinki, Helsinki, Finland.
Heart. 2010 Aug;96(16):1281-6. doi: 10.1136/hrt.2009.190868.
To examine whether a history of stressful life events and prolonged mental stress are associated with arrhythmic events in inherited long QT syndrome (LQTS).
Participants who had a molecularly established mutation of KCNQ1, KCNH2 or SCN5A channel and were thus diagnosed as patients with LQT1, LQT2 and LQT3 (n=566), accordingly. The control group consisted of their 614 non-affected relatives. A history of stressful life events was indexed by the major stressful life events. Prolonged mental stress was indexed by vital exhaustion (VE), which was measured with the Maastricht Questionnaire.
Multinomial logistic regression analysis including patients with LQTS with and without arrhythmic events and the control subjects showed an age- and sex-adjusted association of stressful life events OR=1.15 (95% CI 1.08 to 1.22) and VE (OR=3.33 (95% CI 1.63 to 6.78)) with symptomatic status of LQTS. Symptomatic patients with LQTS had experienced more stressful life events (OR=1.16 (95% CI 1.08 to 1.24)) and the level of VE (OR=3.40 (95% CI 1.44 to 8.03)) was more than three times higher among patients with LQTS with arrhythmic events than in asymptomatic LQTS mutation carriers. The association between stressful life events and arrhythmic events was independent of age, sex, specifically focused medication and LQTS subtype.
A history of stressful life events and prolonged mental stress are associated with arrhythmic events in LQTS in this large sample of molecularly defined patients with LQTS. It is important for future studies to assess how strong these predisposing factors are for arrhythmic events in LQTS.
探讨应激性生活事件史和长期精神压力是否与遗传性长 QT 综合征（LQTS）中的心律失常事件相关。
参与者具有分子上确立的 KCNQ1、KCNH2 或 SCN5A 通道突变，因此被诊断为 LQT1、LQT2 和 LQT3 患者（n=566）。对照组由 614 名无血缘关系的亲属组成。应激性生活事件史由主要应激性生活事件指标索引，长期精神压力由生命力耗竭（VE）指标索引，采用马斯特里赫特问卷进行测量。
多变量逻辑回归分析包括有和无心律失常事件的 LQTS 患者和对照组，发现应激性生活事件（OR=1.15（95% CI 1.08 至 1.22））和 VE（OR=3.33（95% CI 1.63 至 6.78））与 LQTS 的症状状态呈年龄和性别调整关联。有症状的 LQTS 患者经历了更多的应激性生活事件（OR=1.16（95% CI 1.08 至 1.24）），并且有心律失常事件的 LQTS 患者的 VE 水平（OR=3.40（95% CI 1.44 至 8.03））比无症状的 LQTS 基因突变携带者高三倍以上。应激性生活事件与心律失常事件之间的关联独立于年龄、性别、特定的针对性药物和 LQTS 亚型。
在这个由分子定义的大型 LQTS 患者样本中，应激性生活事件史和长期精神压力与 LQTS 中的心律失常事件相关。未来的研究评估这些易感因素在 LQTS 中对心律失常事件的影响程度很重要。
