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Heart-focused anxiety in patients with chronic heart failure before implantation of an implantable cardioverter defibrillator: baseline findings of the Anxiety-CHF Study

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Abstract

Aims

We analysed heart-focused anxiety (HFA) and its predictors in patients with heart failure before implantation of an implantable cardioverter defibrillator (ICD). Herein, we report the baseline data of the Anxiety-CHF Study which investigates HFA before and after ICD implantation.

Methods and results

HFA, general anxiety and depression, perceived quality of life (QoL) and type D personality were measured with validated psychological instruments. Clinical parameters such as severity of heart failure measured by NYHA class and left ventricular ejection fraction (EF) were determined. One hundred and ten patients were interrogated before ICD implantation (70 % male, mean age = 60.5 ± 14.9 years, mean EF = 31 % ± 9 %, 91 % NYHA II–III, 92 % primary prevention). HFA was present in 53 patients (48.6 %); 37 participants (33.9 %) showed increased levels of general anxiety and 33 patients (30.3 %) showed increased levels of depression with clinical significant levels in 16 subjects (14.7 %) for general anxiety and 13 subjects (11.9 %) for depression. Poor QoL was reported in 30 patients (27.5 %). HFA was correlated with QoL, general anxiety, depression, type D personality, myocardial infarction (MI), and systolic blood pressure. QoL, general anxiety and former MI were significant predictors of HFA (R 2 = 0.453).

Conclusion

Heart-focused anxiety is highly prevalent in heart failure patients prior to ICD implantation. Measures of disease severity such as EF or NYHA class do not predict HFA, neither does Type D personality. HFA is predicted by a history of MI and psychological parameters such as general anxiety and impaired QoL.

ClinicalTrials.gov identifier

NCT02226770.

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Author information

Authors and Affiliations

  1. Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany

    Maxie Bunz, Denise Lenski, Sonja Wedegärtner, Christian Ukena, Michael Böhm & Ingrid Kindermann

  2. Psychotherapy Practice, Saarbrücken, Germany

    Denise Lenski

  3. Institut für Psychologie, Goethe-Universität, Frankfurt, Germany

    Julia Karbach

Authors
  1. Maxie Bunz
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  2. Denise Lenski
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  3. Sonja Wedegärtner
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  4. Christian Ukena
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  5. Julia Karbach
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  6. Michael Böhm
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  7. Ingrid Kindermann
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Corresponding authors

Correspondence to Maxie Bunz or Ingrid Kindermann.

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Ethical standards

The investigation complied with the principles outlined in the Declaration of Helsinki. Written informed consent was obtained from each study participant. The Ethics Committee of the Saarland Medical Association approved this study.

Funding

This work was supported by a research grant from the Friede Springer Heart Foundation.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Bunz, M., Lenski, D., Wedegärtner, S. et al. Heart-focused anxiety in patients with chronic heart failure before implantation of an implantable cardioverter defibrillator: baseline findings of the Anxiety-CHF Study. Clin Res Cardiol 105, 216–224 (2016). https://doi.org/10.1007/s00392-015-0909-1

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  • DOI: https://doi.org/10.1007/s00392-015-0909-1

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