Autogenic training to manage symptomology in women with chest pain and normal coronary arteries.
OBJECTIVE
To explore autogenic training (AT) as a treatment for psychological morbidity, symptomology, and physiological markers of stress among women with chest pain, a positive exercise test for myocardial ischemia, and normal coronary arteries (cardiac syndrome X).


METHODS
Fifty-three women with cardiac syndrome X (mean +/- SD age, 57.1 +/- 8 years) were randomized to an 8-week AT program or symptom diary control. Symptom severity and frequency, Hospital Anxiety and Depression Scale, Spielberger State-Trait Anxiety Inventory, Cardiac Anxiety Questionnaire (CAQ), and Ferrans and Powers Quality of Life Index (QLI), blood pressure, heart rate, electrocardiogram, and plasma catecholamines were measured before and after intervention and at the 8-week follow-up.


RESULTS
Women who underwent AT had improved symptom frequency (8.04 +/- 10.08 vs 1.66 +/- 2.19, P < 0.001) compared with control women and reduced symtom severity (2.08 +/- 1.03 vs 1.23 +/- 1.36, P = 0.02) and frequency (6.11 +/- 3.17 vs 1.66 +/- 2.19, P < G 0.001) post-AT compared with baseline within group. Within-group improvements among women who underwent AT include QLI health functioning (17.80 +/- 5.74 vs 19.41 +/- 5.19, P = 0.04) and CAQ fear (1.53 +/- 0.61 vs 1.35 +/- 0.56, P = 0.02) post-AT and QLI health functioning (17.80 +/- 5.74 vs 20.09 +/- 5.47, P = 0.01), CAQ fear (1.53 +/- 0.61 vs 1.30 +/- 0.67, P = 0.002), CAQ total (1.42 +/- 0.54 vs 1.29 +/- 0.475, P = 0.04), Spielberger State-Trait Anxiety Inventory trait anxiety (42.95 +/- 11.19 vs 38.68 +/- 11.47, P = 0.01), and QLI quality of life (20.67 +/- 5.37 vs 21.9 +/- 4.89, P = 0.02) at follow-up.


CONCLUSIONS
An 8-week AT program improves symptom frequency, with near-significant improvements in symptom severity in women with cardiac syndrome X.
Asbury
Elizabeth A
EA
Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College London, London, UK. e.asbury@imperial.ac.uk
Kanji
Nasim
N
Ernst
Edzard
E
Barbir
Mahmoud
M
Collins
Peter
P
D000368:Aged; D001007:Anxiety; D001326:Autogenic Training; D001794:Blood Pressure; D002395:Catecholamines / Q000097:blood; D002637:Chest Pain / Q000523:psychology / Q000628:therapy*; D003331:Coronary Vessels; D003863:Depression; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D017566:Microvascular Angina / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D017202:Myocardial Ischemia; D011788:Quality of Life
D002395:Catecholamines