Ouaddi Sara, Keirns Natalie G, Lee Sharon Y, Dunsiger Shira, Gathright Emily, Burg Matthew, Breault Christopher, Tripolone Janice, Salmoirago-Blotcher Elena
Brown University Health Cardiovascular Institute, The Miriam Hospital, 180 Corliss St, Providence, RI 02904, USA.
Department of Nutrition and Health Science, Ball State University, 1615 W. Riverside Ave, Muncie, IN 47303, USA.
Eur J Cardiovasc Nurs. 2025 Apr 11;24(3):434-443. doi: 10.1093/eurjcn/zvae148.
This secondary analysis aimed to (i) describe psychological resources and distress in women with takotsubo syndrome (TS) and (ii) explore whether such factors affect blood pressure (BP) responses to acute mental stress.
Participants were 47 women consecutively enrolled in an ongoing study examining the prognostic significance of stress reactivity in TS. Psychological resources (resilience and adaptive coping) and distress [depression, anxiety, post-traumatic stress disorder (PTSD), and perceived stress] were self-reported using validated questionnaires <12 weeks after TS. Using a standardized protocol, systolic BP (SBP) and diastolic BP (DBP) (mmHg) were measured every 5 min during baseline (10 min), mental stress (10 min), and recovery (20 min). Associations of psychological resources and distress (high vs. low composite scores), respectively, with BP during mental stress and recovery (change from baseline), were examined using one-way analyses of covariance (covariates: age and anti-hypertensive medications). Given the study's exploratory nature, results are shown as effect sizes. On average, women (Mage = 64.3 years) had high perceived stress, anxiety, and PTSD symptoms and low resilience. Women with high (vs. low) psychological distress displayed less complete SBP (d = 0.57) and DBP (d = 0.33) recovery to baseline. Women with low (vs. high) psychological resources demonstrated lower SBP responses during mental stress (d = -0.26) alongside a more complete SBP recovery (d = 0.30).
Female survivors of TS with high psychological distress exhibited impaired BP recovery following acute mental stress. While the prognostic significance of impaired BP recovery from mental stress remains to be determined in longitudinal studies, this finding could help identify TS survivors at risk for recurrence.
本二次分析旨在（i）描述应激性心肌病（TS）女性患者的心理资源和心理困扰，以及（ii）探讨这些因素是否会影响急性精神应激时的血压（BP）反应。
参与者为47名连续纳入一项正在进行的研究的女性，该研究旨在探讨应激反应性在TS中的预后意义。在TS发病后<12周，使用经过验证的问卷对心理资源（心理韧性和适应性应对）和心理困扰[抑郁、焦虑、创伤后应激障碍（PTSD）和感知压力]进行自我报告。采用标准化方案，在基线期（10分钟）、精神应激期（10分钟）和恢复期（20分钟）每隔5分钟测量一次收缩压（SBP）和舒张压（DBP）（mmHg）。分别使用协方差分析（协变量：年龄和抗高血压药物）检验心理资源和心理困扰（高复合评分与低复合评分）与精神应激期和恢复期（相对于基线的变化）血压之间的关联。鉴于该研究的探索性质，结果以效应量表示。平均而言，女性（年龄中位数 = 64.3岁）感知压力、焦虑和PTSD症状较高，心理韧性较低。心理困扰程度高（与低相比）的女性SBP（d = 0.57）和DBP（d = 0.33）恢复到基线的程度较差。心理资源低（与高相比）的女性在精神应激期间SBP反应较低（d = -0.26），同时SBP恢复更完全（d = 0.30）。
心理困扰程度高的TS女性幸存者在急性精神应激后血压恢复受损。虽然精神应激后血压恢复受损在纵向研究中的预后意义仍有待确定，但这一发现有助于识别有复发风险的TS幸存者。
