title: The relevance of accuracy of heartbeat perception in noncardiac and cardiac chest pain.
abstract: BACKGROUND
  The development and course of noncardiac chest pain are assumed to be influenced by interoceptive processes.
  
  
  OBJECTIVE
  It was investigated whether heartbeat perception was enhanced in patients suffering from noncardiac chest pain and to what degree it was associated with self-reported cognitive-perceptual features and chest pain characteristics.
  
  
  METHODS
  A total of 42 patients with noncardiac chest pain (NCCP), 35 patients with cardiac chest pain, and 52 healthy controls were recruited. Heartbeat perception was assessed using the Schandry task and a modified Brener-Kluvitse task. Self-report measures assessed anxiety sensitivity, somatosensory amplification, heart-focused anxiety, and chest pain characteristics.
  
  
  RESULTS
  Heartbeat perception was not more accurate in patients with NCCP, compared to patients with cardiac chest pain and healthy controls. However, in patients with NCCP, the error score (Schandry task) was significantly associated with stronger chest pain impairment, and the response bias (Brener-Kluvitse task) was associated with lower chest pain intensity.
  
  
  CONCLUSIONS
  Against assumptions of current etiological models, heartbeat perception was not enhanced in patients with NCCP. Chest pain characteristics and particularly their appraisal as threatening might be more relevant to NCCP than the perceptional accuracy of cardiac sensations and should be focused in psychological interventions. However, associations with chest pain impairment suggest cardiac interoception to influence the course of NCCP.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany, stefanie.schroeder@uk-erlangen.de.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schroeder
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Gerlach
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
authors.forename: Alexandra
authors.initials: A
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D016022:Case-Control Studies; D002637:Chest Pain / Q000209:etiology / Q000523:psychology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D057566:Self Report; D012677:Sensation