Dreher Helena, Dewald Oliver, Freiberger Annika, Freilinger Sebastian, Harig Frank, Nagdyman Nicole, Strueven Nina Theresa, Suleiman Mathieu, Mellert Fritz, Kohls Niko, Kaemmerer-Suleiman Ann-Sophie
International Center for Adults with Congenital Heart Disease, Department of Congenital Heart Disease and Pediatric Cardiology, TUM University Hospital, German Heart Center Munich, Munich, Germany.
Department of Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany.
Cardiovasc Diagn Ther. 2025 Aug 30;15(4):781-791. doi: 10.21037/cdt-2025-224. Epub 2025 Aug 15.
Aortopathies do not only occur in acquired heart disease but are often associated with congenital heart defects (CHD) or hereditary connective tissue disease (HCTD). Individuals diagnosed with these conditions have an increased risk of life-threatening events, such as aortic dissection or rupture. The diagnosis of an aortopathy or the occurrence of complications are life-changing and psychologically stressful events, possibly inducing post-traumatic stress symptoms (PTSS) and a reduced quality of life (QoL). This study aimed to estimate the prevalence of PTSS and QoL related to cardiological parameters in adults with aortopathies and CHD or HCTD.
This retrospective epidemiological cross-sectional study enrolled 137 adults with aortopathies and CHD or HCTD between May 2024 and October 2024. PTSS and QoL were assessed using the Posttraumatic Diagnostic Scale, the Impact of Event Scale-Revised, the Short Form-36, and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The reasons for PTSS were explored using free-text responses. Descriptive analyses were performed to assess measures of central tendency and distribution. To examine differences and associations, non-parametric tests and Spearman's rank correlation were applied, and logistic regression models were used to further investigate medical and psychological associations.
Overall, 5.8% (n=8) to 7.3% (n=10) of the enrolled patients [mean age: 41.1±10.8 (18 to 63) years; 54% women] showed elevated PTSS indicative of clinical concern related to their aortopathy. Between pre-existing psychological disorders and PTSS, a significant association could be observed (odds ratio: 9.71, P=0.007). Cardiac parameters were not significantly associated with developing PTSS. Free-text responses showed a wide range of distressing events, ranging from anxiety, pain or shock to physical limitations. Overall QoL was good, although patients with PTSS showed a lower QoL (MLHFQ: 12.30 . 21.90, P=0.004).
Despite the low prevalence of PTSS and generally good QoL, our findings underscore the importance of incorporating psychological screening into standard care for patients with CHD or HCTD with aortopathies. A holistic approach that goes beyond the medical management of aortopathies and includes comprehensive psychological support is essential in optimizing patient outcomes.
主动脉病变不仅发生于后天性心脏病，还常与先天性心脏缺陷（CHD）或遗传性结缔组织病（HCTD）相关。被诊断患有这些疾病的个体发生危及生命事件的风险增加，如主动脉夹层或破裂。主动脉病变的诊断或并发症的发生是改变生活且造成心理压力的事件，可能诱发创伤后应激症状（PTSS）并降低生活质量（QoL）。本研究旨在评估患有主动脉病变以及CHD或HCTD的成年人中与心脏参数相关的PTSS患病率及QoL。
这项回顾性流行病学横断面研究在2024年5月至2024年10月期间纳入了137例患有主动脉病变以及CHD或HCTD的成年人。使用创伤后诊断量表、事件影响量表修订版、简明健康调查问卷36项版（Short Form-36）以及明尼苏达心力衰竭生活问卷（MLHFQ）评估PTSS和QoL。通过自由文本回答探索PTSS的原因。进行描述性分析以评估集中趋势和分布的测量指标。为检验差异和关联，应用非参数检验和Spearman等级相关性分析，并使用逻辑回归模型进一步研究医学和心理方面的关联。
总体而言，纳入的患者中5.8%（n = 8）至7.3%（n = 10）[平均年龄：41.1±10.8（18至63）岁；54%为女性]表现出PTSS升高，表明其主动脉病变存在临床相关问题。在既往存在的心理障碍与PTSS之间可观察到显著关联（比值比：9.71，P = 0.007）。心脏参数与PTSS的发生无显著关联。自由文本回答显示了广泛的痛苦事件，从焦虑、疼痛或震惊到身体限制。总体QoL良好，尽管患有PTSS的患者QoL较低（MLHFQ：12.30对21.90，P = 0.004）。
尽管PTSS患病率较低且总体QoL良好，但我们的研究结果强调了将心理筛查纳入患有主动脉病变的CHD或HCTD患者标准护理的重要性。一种超越主动脉病变医学管理并包括全面心理支持的整体方法对于优化患者结局至关重要。
