Saffari Mohsen, Lin Chung-Ying, Broström Anders, Mårtensson Jan, Malm Dan, Burri Andrea, Fridlund Bengt, Pakpour Amir H
1 Health Research Center, Baqiyatallah University of Medical Sciences Tehran, Iran.
2 Health Education Department, School of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Eur J Cardiovasc Nurs. 2017 Oct;16(7):614-622. doi: 10.1177/1474515117702028. Epub 2017 Mar 23.
Takotsubo cardiomyopathy (TSCM) has detrimental effects on both physical and psychological health of sufferers. However, little is known whether TSCM also affects sexual functioning in female patients.
The aim of this study was to investigate psychological distress (depression and anxiety), health-related quality of life, and sexual functioning in women with TSCM and compare them with women with acute myocardial infarction and with healthy controls.
A three group prospective case-control design was used. Female patients with TSCM or acute myocardial infarction, as well as healthy controls (94 in each group), were recruited across eight Iranian university hospitals. Data were collected at baseline and after six and 18 months using the Hospital Anxiety and Depression Scale, the Short Form-12, the Female Sexual Function Index and the Female Sexual Distress Scale. Multilevel logistic regression was conducted.
The TSCM group showed worst sexual functioning and the highest level of anxiety and depression at baseline ( p<0.01) compared with the two other groups. The TSCM and AMI groups showed comparable health-related quality of life at baseline, which was lower in both groups compared with the healthy controls ( p<0.01). Overall, depression, anxiety and health-related quality of life showed a significant change over time, especially in the TSCM group, with health-related quality of life decreasing, while anxiety and depression were increasing. Compared with the acute myocardial infarction and healthy control groups, the TSCM group showed a higher prevalence of sexual problems (odds ratios = 3.10 and 2.28, respectively) across time. Moreover, sexual functioning was found to be a mediator between anxiety and health-related quality of life in the TSCM group.
Depression, anxiety, health-related quality of life, and sexual dysfunction tend to increase over time in female patients with TSCM; thus, healthcare providers should pay attention to these problems and provide appropriate treatment where necessary.
应激性心肌病（TSCM）对患者的身心健康均有不利影响。然而，应激性心肌病是否也会影响女性患者的性功能却鲜为人知。
本研究旨在调查应激性心肌病女性患者的心理困扰（抑郁和焦虑）、健康相关生活质量及性功能，并将她们与急性心肌梗死女性患者及健康对照者进行比较。
采用三组前瞻性病例对照设计。在伊朗的八所大学医院招募了应激性心肌病或急性心肌梗死的女性患者以及健康对照者（每组94人）。在基线、6个月和18个月后使用医院焦虑抑郁量表、简明健康调查量表12项、女性性功能指数和女性性困扰量表收集数据。进行多水平逻辑回归分析。
与其他两组相比，应激性心肌病组在基线时性功能最差，焦虑和抑郁水平最高（p<0.01）。应激性心肌病组和急性心肌梗死组在基线时的健康相关生活质量相当，与健康对照组相比，两组的健康相关生活质量均较低（p<0.01）。总体而言，抑郁、焦虑和健康相关生活质量随时间有显著变化，尤其是在应激性心肌病组，健康相关生活质量下降，而焦虑和抑郁增加。与急性心肌梗死组和健康对照组相比，应激性心肌病组在各个时间点的性问题患病率更高（优势比分别为3.10和2.28）。此外，在应激性心肌病组中，性功能被发现是焦虑与健康相关生活质量之间的中介因素。
应激性心肌病女性患者的抑郁、焦虑、健康相关生活质量和性功能障碍往往随时间增加；因此，医疗服务提供者应关注这些问题，并在必要时提供适当治疗。
