Department of Neurology, Division of Critical Care & Hospitalist Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital, Milstein Hospital, 177 Fort Washington Avenue, New York, NY, 8GS-300, USA.
Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, USA.
Curr Cardiol Rep. 2022 Oct;24(10):1351-1360. doi: 10.1007/s11886-022-01747-9. Epub 2022 Aug 3.
To summarize the prevalence, correlates, and health consequences of poor mental health in the increasingly sizable population of survivors of Sudden cardiac arrest (CA) and to describe current intervention research in this area.
After CA many patients report high psychological distress, including depression, generalized anxiety, and posttraumatic stress. Emerging evidence suggests that distressed patients' attention may narrow such that anxious awareness of afferent cardiac signals e.g., changes in heart rate or blood pressure, becomes predominant and a cause for concerned, constant monitoring. This cardiac-specific anxiety followed by behavioral avoidance and physiological hyperreactivity may increase patients' already high risk of secondary cardiovascular disease and undermine their health-related quality of life (HRQoL). Unlike other cardiovascular diseases, no clinical practice guidelines exist for assessing or treating psychological sequelae of CA. Future research should identify modifiable psychological targets to reduce secondary cardiovascular disease risk and improve HRQoL.
总结日益庞大的心脏骤停幸存者人群中心理健康不良的患病率、相关因素和健康后果,并描述该领域当前的干预研究。
心脏骤停后,许多患者报告存在高度心理困扰,包括抑郁、广泛性焦虑和创伤后应激。新出现的证据表明,痛苦的患者注意力可能会变窄,从而使传入的心脏信号(例如心率或血压的变化)引起焦虑的意识变得突出,并成为关注和持续监测的原因。这种心脏特异性焦虑随后是行为回避和生理过度反应,可能会增加患者已经很高的继发心血管疾病风险,并损害他们的健康相关生活质量(HRQoL)。与其他心血管疾病不同,目前尚无评估或治疗心脏骤停后心理后果的临床实践指南。未来的研究应确定可改变的心理目标,以降低继发心血管疾病风险并提高 HRQoL。