title: Left Ventricular Ejection Fraction Predicts Severity of Posttraumatic Stress Disorder in Patients With Implantable Cardioverter-Defibrillators.
abstract: BACKGROUND
  Implantable cardioverter-defibrillators (ICD) have provided effective therapy for fatal arrhythmia. However, ICD patients are known to develop psychological problems, such as posttraumatic stress disorder (PTSD), if they have experienced potentially fatal arrhythmia and ICD shocks. Little is known about the factors influencing PTSD in ICD patients.
  
  
  OBJECTIVE
  Echocardiographic cardiac-function parameters might relate to psychological problems, especially PTSD, in ICD patients.
  
  
  METHODS
  A total of 128 outpatients with ICD implantation completed the Impact of Event Scale Revised (IES-R) questionnaire as a measurement of PTSD. Demographic and clinical characteristic data were collected from medical records.
  
  
  RESULTS
  The mean age of the ICD patients was 59 ± 16 years; 103 were male; and the mean left ventricular ejection fraction (LVEF) by echocardiography was 52.4% ± 18.3%. In the ICD patients, female sex and impaired LVEF were related to lower IES-R scores or led to PTSD (P = 0.01 and P = 0.03, respectively). Impaired LVEF also worsened 2 symptoms of PTSD, intrusion (P = 0.02) and hyperarousal (P = 0.03). In patients with LVEF <35%, there was a significant negative correlation between LVEF level and IES-R score (P = 0.045).
  
  
  CONCLUSIONS
  This study showed that LVEF was related to the severity of PTSD, especially in the ICD patients with LVEF of <35%. We should pay more attention to ICD patients with severely impaired left ventricular function to prevent psychological problems.
authors.affiliation: Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sawatari
authors.affiliation: Center for Clinical and Translational Research, Kyushu University, Fukuoka, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ohkusa
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Anita
authors.initials: A
authors.lastname: Rahamawati
authors.affiliation: Institutional Research Office for Education, Education Promotion Center, Prefectural University of Kumamoto, Kumamoto, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Ishikawa
authors.affiliation: Department of Nursing, Kitasato University, Sagamihara, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Tsuchihashi-Makaya
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ohtsuka
authors.affiliation: Tokyo Metropolitan Health and Medical Treatment Corporation Ookubo Hospital, Tokyo, Japan.
authors.forename: Mori
authors.initials: M
authors.lastname: Nakai
authors.affiliation: School of Nursing, Fukuoka Prefectural University, Fukuoka, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Miyazono
authors.affiliation: Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Hashiguchi
authors.affiliation: Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.|Department of Healthcare Management, College of Healthcare Management, Fukuoka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Chishaki
authors.affiliation: Tokyo Metropolitan Health and Medical Treatment Corporation Ookubo Hospital, Tokyo, Japan.
authors.forename: Harumizu
authors.initials: H
authors.lastname: Sakurada
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Mukai
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Shujiro
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sunagawa
authors.affiliation: Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.|Department of Healthcare Management, College of Healthcare Management, Fukuoka, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Chishaki
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable; D004452:Echocardiography; D004554:Electric Countershock / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left