Giolo Renata Lima, Fenelon Guilherme, Franken Marcelo, Katz Marcelo
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2025 Mar 24;23:eAO0742. doi: 10.31744/einstein_journal/2025AO0742. eCollection 2025.
Depression, anxiety, distress and Type D personality traits have been implicated in the pathogenesis of cardiovascular diseases. Mental health status is associated with arrhythmic events. Esler and Lampert reported that anxiety and distress contribute to the occurrence of atrial and ventricular arrhythmias. ■ Self-reported cardiac symptoms not associated with arrhythmias. ■ High prevalence of anxiety and depression symptoms. ■ Anxiety was correlated with self-reported cardiac symptoms.
This study aimed to examine the presence of psychological characteristics and their association with self-reported cardiac symptoms in individuals undergoing 24-hour Holter monitoring.
This observational cross-sectional study included 304 individuals who consecutively underwent 24-hour Holter monitoring. Clinical, demographic, and electrocardiographic data were collected. Psycho-behavioral characteristics were assessed using the Hospital Anxiety and Depression Scale and the Type D Scale. Logistic regression models were employed to examine associations between cardiac symptoms and anxiety, depression, distress, and Type D personality traits. Statistical significance was set at p<0.05.
Anxiety, depression, distress, and type D personality traits were observed in 42.7%, 15.1%, 26.3%, and 19% of the participants, respectively. Logistic regression analysis revealed a significant association between the perception of cardiac symptoms and both mild anxiety (odds ratio (OR) = 2.305, 95%CI= 1.098-4.841, p=0.027) and severe anxiety (OR = 9.245, 95%CI= 1.582-54.013, p=0.014) scores. No significant association was found between depression, distress, or Type D personality traits and an increased perception of cardiac symptoms.
A high prevalence of anxiety was observed among individuals undergoing 24-hour Holter recording. Anxiety was significantly associated with self-reported cardiac symptoms, though not with the presence of arrhythmias. The findings could have practical implications for clinical practice. The study suggests that patients reporting anxious palpitations should receive a more thorough cardiological assessment, with 24-hour Holter monitoring serving as an effective tool for this evaluation.
抑郁、焦虑、痛苦和D型人格特质与心血管疾病的发病机制有关。心理健康状况与心律失常事件相关。埃斯勒和兰珀特报告称，焦虑和痛苦会导致房性和室性心律失常的发生。
自我报告的与心律失常无关的心脏症状。
焦虑和抑郁症状的高患病率。
焦虑与自我报告的心脏症状相关。
本研究旨在调查接受24小时动态心电图监测的个体的心理特征及其与自我报告的心脏症状的关联。
这项观察性横断面研究纳入了304名连续接受24小时动态心电图监测的个体。收集了临床、人口统计学和心电图数据。使用医院焦虑抑郁量表和D型量表评估心理行为特征。采用逻辑回归模型来检验心脏症状与焦虑、抑郁、痛苦和D型人格特质之间的关联。设定统计学显著性为p<0.05。
分别有42.7%、15.1%、26.3%和19%的参与者存在焦虑、抑郁、痛苦和D型人格特质。逻辑回归分析显示，心脏症状的感知与轻度焦虑（比值比（OR）=2.305，95%置信区间=1.098 - 4.841，p = 0.027）和重度焦虑（OR = 9.245，95%置信区间=1.582 - 54.013，p = 0.014）评分之间存在显著关联。未发现抑郁、痛苦或D型人格特质与心脏症状感知增加之间存在显著关联。
在接受24小时动态心电图记录的个体中观察到高患病率的焦虑。焦虑与自我报告的心脏症状显著相关，但与心律失常的存在无关。这些发现可能对临床实践具有实际意义。该研究表明，报告有心悸焦虑的患者应接受更全面的心脏病学评估，24小时动态心电图监测是进行此项评估的有效工具。
