Psycho-emotional manifestations of valvular heart diseases: Prospective assessment in mitral regurgitation

Tali Bayer-Topilsky, Max R. Trenerry, Rakesh Suri, Yan Topilsky, Ryan M. Antiel, Yariv Marmor, Douglas W. Mahoney, Hartzell V Schaff, Maurice E Sarano

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective To define the prevalence and consequences of post-traumatic stress disorder (PTSD) as an emotional response to cardiac diseases in patients with mitral regurgitation. Methods We prospectively enrolled 186 patients with moderate or severe organic mitral regurgitation, presenting class I (absent) or II (minimal) dyspnea, who were compared with 80 controls of similar age (38 with completely normal cardiac function; 42 with mild mitral-valve prolapse; all with no, or at most mild, mitral regurgitation). Mitral-regurgitation severity and consequences were comprehensively measured, simultaneously with PTSD, anxiety, and depression. Results PTSD prevalence was higher in mitral-regurgitation patients vs controls (23% vs 9%, P <.01). Although mitral-regurgitation objective severity (regurgitant volume 77.8 ± 28.9 vs 79.0 ± 27.5 mL, P =.8) and objective consequences (left-atrial volume 59.1 ± 20.9 vs 54.02 ± 15.6 mL, P =.1; right-ventricular systolic pressure 34.1 ± 11.4 vs 32.9 ± 7.2 mm Hg, P =.6) were similar with and without PTSD (all P ≥.1), patients with PTSD were more symptomatic (class II 74 vs 38%; fatigue 71% vs 38%, both P <.0001) and had higher anxiety and depressions scores (P <.0001). Conclusions PTSD is prevalent in organic moderate or severe mitral-regurgitation patients but is not determined by objective mitral-regurgitation severity or consequences. PTSD is linked to anxiety and depression and to symptoms usually considered cardiac, such as dyspnea. Thus, PTSD and psycho-emotional manifestations, linked to symptoms, represent important responses to chronic-valve disease that may affect clinical outcomes.

Original languageEnglish (US)
Pages (from-to)916-924
Number of pages9
JournalAmerican Journal of Medicine
Volume126
Issue number10
DOIs
StatePublished - Oct 2013

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Heart Valve Diseases
Mitral Valve Insufficiency
Post-Traumatic Stress Disorders
Anxiety
Depression
Dyspnea
Mitral Valve Prolapse
Ventricular Pressure
Fatigue
Heart Diseases
Chronic Disease
Blood Pressure

Keywords

  • Chronic mitral regurgitation PTSD Symptoms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Psycho-emotional manifestations of valvular heart diseases : Prospective assessment in mitral regurgitation. / Bayer-Topilsky, Tali; Trenerry, Max R.; Suri, Rakesh; Topilsky, Yan; Antiel, Ryan M.; Marmor, Yariv; Mahoney, Douglas W.; Schaff, Hartzell V; Sarano, Maurice E.

In: American Journal of Medicine, Vol. 126, No. 10, 10.2013, p. 916-924.

Research output: Contribution to journalArticle

Bayer-Topilsky, Tali ; Trenerry, Max R. ; Suri, Rakesh ; Topilsky, Yan ; Antiel, Ryan M. ; Marmor, Yariv ; Mahoney, Douglas W. ; Schaff, Hartzell V ; Sarano, Maurice E. / Psycho-emotional manifestations of valvular heart diseases : Prospective assessment in mitral regurgitation. In: American Journal of Medicine. 2013 ; Vol. 126, No. 10. pp. 916-924.
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abstract = "Objective To define the prevalence and consequences of post-traumatic stress disorder (PTSD) as an emotional response to cardiac diseases in patients with mitral regurgitation. Methods We prospectively enrolled 186 patients with moderate or severe organic mitral regurgitation, presenting class I (absent) or II (minimal) dyspnea, who were compared with 80 controls of similar age (38 with completely normal cardiac function; 42 with mild mitral-valve prolapse; all with no, or at most mild, mitral regurgitation). Mitral-regurgitation severity and consequences were comprehensively measured, simultaneously with PTSD, anxiety, and depression. Results PTSD prevalence was higher in mitral-regurgitation patients vs controls (23{\%} vs 9{\%}, P <.01). Although mitral-regurgitation objective severity (regurgitant volume 77.8 ± 28.9 vs 79.0 ± 27.5 mL, P =.8) and objective consequences (left-atrial volume 59.1 ± 20.9 vs 54.02 ± 15.6 mL, P =.1; right-ventricular systolic pressure 34.1 ± 11.4 vs 32.9 ± 7.2 mm Hg, P =.6) were similar with and without PTSD (all P ≥.1), patients with PTSD were more symptomatic (class II 74 vs 38{\%}; fatigue 71{\%} vs 38{\%}, both P <.0001) and had higher anxiety and depressions scores (P <.0001). Conclusions PTSD is prevalent in organic moderate or severe mitral-regurgitation patients but is not determined by objective mitral-regurgitation severity or consequences. PTSD is linked to anxiety and depression and to symptoms usually considered cardiac, such as dyspnea. Thus, PTSD and psycho-emotional manifestations, linked to symptoms, represent important responses to chronic-valve disease that may affect clinical outcomes.",
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AU - Bayer-Topilsky, Tali

AU - Trenerry, Max R.

AU - Suri, Rakesh

AU - Topilsky, Yan

AU - Antiel, Ryan M.

AU - Marmor, Yariv

AU - Mahoney, Douglas W.

AU - Schaff, Hartzell V

AU - Sarano, Maurice E

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N2 - Objective To define the prevalence and consequences of post-traumatic stress disorder (PTSD) as an emotional response to cardiac diseases in patients with mitral regurgitation. Methods We prospectively enrolled 186 patients with moderate or severe organic mitral regurgitation, presenting class I (absent) or II (minimal) dyspnea, who were compared with 80 controls of similar age (38 with completely normal cardiac function; 42 with mild mitral-valve prolapse; all with no, or at most mild, mitral regurgitation). Mitral-regurgitation severity and consequences were comprehensively measured, simultaneously with PTSD, anxiety, and depression. Results PTSD prevalence was higher in mitral-regurgitation patients vs controls (23% vs 9%, P <.01). Although mitral-regurgitation objective severity (regurgitant volume 77.8 ± 28.9 vs 79.0 ± 27.5 mL, P =.8) and objective consequences (left-atrial volume 59.1 ± 20.9 vs 54.02 ± 15.6 mL, P =.1; right-ventricular systolic pressure 34.1 ± 11.4 vs 32.9 ± 7.2 mm Hg, P =.6) were similar with and without PTSD (all P ≥.1), patients with PTSD were more symptomatic (class II 74 vs 38%; fatigue 71% vs 38%, both P <.0001) and had higher anxiety and depressions scores (P <.0001). Conclusions PTSD is prevalent in organic moderate or severe mitral-regurgitation patients but is not determined by objective mitral-regurgitation severity or consequences. PTSD is linked to anxiety and depression and to symptoms usually considered cardiac, such as dyspnea. Thus, PTSD and psycho-emotional manifestations, linked to symptoms, represent important responses to chronic-valve disease that may affect clinical outcomes.

AB - Objective To define the prevalence and consequences of post-traumatic stress disorder (PTSD) as an emotional response to cardiac diseases in patients with mitral regurgitation. Methods We prospectively enrolled 186 patients with moderate or severe organic mitral regurgitation, presenting class I (absent) or II (minimal) dyspnea, who were compared with 80 controls of similar age (38 with completely normal cardiac function; 42 with mild mitral-valve prolapse; all with no, or at most mild, mitral regurgitation). Mitral-regurgitation severity and consequences were comprehensively measured, simultaneously with PTSD, anxiety, and depression. Results PTSD prevalence was higher in mitral-regurgitation patients vs controls (23% vs 9%, P <.01). Although mitral-regurgitation objective severity (regurgitant volume 77.8 ± 28.9 vs 79.0 ± 27.5 mL, P =.8) and objective consequences (left-atrial volume 59.1 ± 20.9 vs 54.02 ± 15.6 mL, P =.1; right-ventricular systolic pressure 34.1 ± 11.4 vs 32.9 ± 7.2 mm Hg, P =.6) were similar with and without PTSD (all P ≥.1), patients with PTSD were more symptomatic (class II 74 vs 38%; fatigue 71% vs 38%, both P <.0001) and had higher anxiety and depressions scores (P <.0001). Conclusions PTSD is prevalent in organic moderate or severe mitral-regurgitation patients but is not determined by objective mitral-regurgitation severity or consequences. PTSD is linked to anxiety and depression and to symptoms usually considered cardiac, such as dyspnea. Thus, PTSD and psycho-emotional manifestations, linked to symptoms, represent important responses to chronic-valve disease that may affect clinical outcomes.

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