title: Relations between depressive symptoms, anxiety, and T Wave abnormalities in subjects without clinically-apparent cardiovascular disease (from the Multi-Ethnic Study of Atherosclerosis [MESA]).
abstract: The aim of this study was to test the hypothesis that depression and anxiety are associated with electrocardiographic (ECG) repolarization abnormalities in the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort free of symptomatic cardiovascular disease. Depressive symptoms were assessed by using the Center for Epidemiologic Studies Depression Scale and trait anxiety symptoms by using the Spielberger State-Trait Anxiety Inventory; both were categorized according to uppermost quartile. T-wave inversions in ECG leads other than V1 to V3 were obtained from electrocardiograms obtained at rest during the baseline examination. Participants with major intraventricular conduction abnormalities and those taking antiarrhythmics, antidepressants, and/or antipsychotics were excluded. Logistic regression models were estimated with multivariable adjustment for traditional cardiovascular disease risk factors. Among 5,906 participants, elevated depressive symptoms were associated with increased odds of T-wave inversion after multivariable adjustment (odds ratio 2.02, 95% confidence interval 1.33 to 3.06, p = 0.001), whereas greater trait anxiety was associated with reduced odds of T-wave inversion (odds ratio 0.47, 95% confidence interval 0.29 to 0.77, p = 0.003). The divergent associations of depressive symptoms and trait anxiety with ECG T-wave inversions were similar in men and women, and these associations were present across the racial and ethnic subgroups (non-Hispanic white, African-American, Hispanic, and Chinese). In conclusion, symptoms of depression and anxiety were independently yet oppositely associated with ECG T-wave inversions. Negative emotions may have a differential impact on cardiovascular mortality through unique relations with cardiac repolarization.
authors.affiliation: Department of Medicine, Columbia University, New York, New York. Electronic address: ww42@cumc.columbia.edu.
authors.forename: William
authors.initials: W
authors.lastname: Whang
authors.affiliation: Department of Medicine, Columbia University, New York, New York.
authors.forename: James
authors.initials: J
authors.lastname: Peacock
authors.affiliation: Department of Epidemiology and Prevention, Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston Salem, North Carolina; Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, North Carolina.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.affiliation: Department of Medicine, Columbia University, New York, New York.
authors.forename: Carmela
authors.initials: C
authors.lastname: Alcantara
authors.affiliation: Department of Cardiology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Saman
authors.initials: S
authors.lastname: Nazarian
authors.affiliation: Department of Epidemiology, Emory University, Atlanta, Georgia.
authors.forename: Amit J
authors.initials: AJ
authors.lastname: Shah
authors.affiliation: Department of Medicine, Columbia University, New York, New York.
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
authors.affiliation: Department of Medicine, Columbia University, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.affiliation: Department of Medicine, Columbia University, New York, New York.
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000208:ethnology* / Q000209:etiology; D050197:Atherosclerosis / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology; D003863:Depression / Q000208:ethnology* / Q000209:etiology; D004562:Electrocardiography; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology