Which psychological, psychophysiological, and anthropometric factors are connected with life events, depression, and quality of life in patients with cardiovascular disease

Milos Slepecky,1 Antonia Kotianova,1,2 Jan Prasko,1,3 Ivan Majercak,4,5 Erika Gyorgyova,5 Michal Kotian,1,2 Marta Zatkova,1 Marta Popelkova,1 Marie Ociskova,3 Ingrid Tonhajzerova6 1Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, 2Psychagogia, Liptovsky Mikulas, Slovak Republic; 3Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 4First Department of Internal Medicine, Faculty of Medicine, Pavol Josef Safarik University in Kosice, 5Internal Medicine and Cardiology Private Practice, MUDr Ivan Majercak, Kosice, 6Department of Physiology and Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia Objective: The aim of the study was to determine psychological, psychophysiological, and anthropometric factors connected with life events, level of depression, and quality of life in people at risk for cardiovascular disease and healthy controls.Methods: This is a cross-sectional study involving arterial hypertension patients and healthy controls. There were several measurements including physical, anthropological, cardiovascular, and psychophysiological measurements and administration of questionnaires.Results: A total of 99 participants were recruited for this study, 54 healthy controls (mean age: 35.59±13.39 years) and 45 patients with cardiovascular disease (CVD) (mean age: 46.33±12.39 years). The healthy controls and the patients with CVD significantly differed in the mean total score of life events, level of depression, quality of life score, temperature, blood pressure (BP), pulse transit time, heart rate, high-frequency total power, heart rate variability total power, waist-to-height ratio (WHtR), body fat percentage, fat control, pulse wave velocity, and augmentation index. In healthy subjects, the total score of the life events was not correlated with any cardiovascular or anthropometric factor. A score of depression significantly correlated with the WHtR, augmentation index, body fat percentage, and fat control. The quality of life – visual scale correlated with the body temperature, BP, and percentage of body fat. In the group of the patients with CVD, the score of the life events did not correlate with any measured cardiovascular or anthropometric factor. The level of depression correlated with the augmentation index. The quality of life – visual scale significantly correlated with body temperature, WHtR, and fat control.Conclusion: The patients with CVD reported higher scores of life events, worse quality of life, and a greater level of depressive symptoms than healthy controls. In healthy controls, a higher mean total score of life events significantly negatively correlated with high-frequency total power, and the degree of depression correlated with being overweight. In patients with CVD, a score of depression was linked to being overweight. Keywords: life events, depression, quality of life, heart rate variability, autonomic nervous system, parameters of cardiovascular syste

Coping, schemas, and cardiovascular risks – study protocol

Milos Slepecky,1 Antonia Kotianova,1 Jan Prasko,2 Ivan Majercak,3 Erika Gyorgyova,4 Michal Kotian,1,5 Marta Zatkova,1 Ingrid Tonhajzerova,6,7 Michaela Chupacova,1,5 Marta Popelkova1 1Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic; 2Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 31st Department of Internal Medicine, Faculty of Medicine, Pavol Josef Safarik University in Košice, 4Internal Medicine and Cardiology Private Practice MUDr Ivan Majercak, Košice, 5Psychagogia, Liptovsky Mikulas, 6Department of Physiology, 7Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic Abstract: The aim of this article is to describe the protocol of a trial focusing on the psychological, anthropometric, cardiac, and psychophysiological factors contributing to increased risk of cardiovascular diseases (CVDs). As background, the article provides a short overview of research literature linking personal traits, maladaptive schemas, and coping styles with CVDs through reactivity of the autonomic nervous system. Keywords: early maladaptive schemas, coping styles, personality traits, dissociation, heart rate variabilit

Prognostic Properties of the GOLD 2023 Classification System

Kristian Brat,1– 3 Michal Svoboda,4 Jaromir Zatloukal,5,6 Marek Plutinsky,1,2 Eva Volakova,5,6 Patrice Popelkova,7,8 Barbora Novotna,9 Tomas Dvorak,10 Vladimir Koblizek11,12 1Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic; 2Faculty of Medicine, Masaryk University, Brno, Czech Republic; 3International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic; 4Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic; 5Pulmonary Department, University Hospital Olomouc, Olomouc, Czech Republic; 6Faculty of Medicine, Palacky University, Olomouc, Czech Republic; 7Pulmonary Department, University Hospital Ostrava, Ostrava, Czech Republic; 8Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; 9Pulmonary Department, Bulovka Hospital, Prague, Czech Republic; 10Pulmonary Department, Mlada Boleslav Hospital, Mlada Boleslav, Czech Republic; 11Pulmonary Department, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; 12Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech RepublicCorrespondence: Kristian Brat, Department of Respiratory Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavska street 20, Brno, 62500, Czech Republic, Tel +420 532 232 556, Email [email protected]: Recently, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published an update on the Global Strategy for Prevention, Diagnosis and Management of COPD, introducing a new classification of chronic obstructive pulmonary disease (COPD). Our aim was to assess the prognostic value of the new GOLD classification system in comparison with the previous GOLD classification systems (GOLD stages I–IV and GOLD groups A-D) and the BODE index.Methods: We used the data of 784 patients with COPD from the Czech Multicenter Research Database of COPD. Patient survival was analyzed with the use of Kaplan–Meier estimate and Cox model of proportional risks. ROC analysis and area under curve (AUC) were used for comparison of GOLD classifications and BODE index. The analyses were performed with the use of software R (version 4.2.0).Results: We analyzed data of 782 patients with complete data on GOLD classifications. The study population comprised 72.9% of men, 89.1% current or former smokers, with a mean age of 66.6 years, a mean BMI of 27.4 and a mean FEV1 44.9% of predicted. Probability of 5-year survival differed by GOLD classification. Application of the 2023 GOLD classification showed increased risk of death in group B (HR 1.82, 95% CI 1.14– 2.92; p = 0.013) and in group E (HR 2.48, 95% CI 1.54– 3.99; p˂0.001). The ROC analysis showed that the overall prognostic value of the 2023 GOLD classification was similarly weak to previous A-D GOLD classification schemes (AUCs 0.557– 0.576) and was lower compared to the GOLD 1– 4 system (AUC 0.614) and even lower when compared to the BODE index (AUC 0.715).Conclusion: We concluded that the new GOLD classification system has poor prognostic properties and that specific prediction tools (eg, the BODE index) should be used for mortality risk assessment.Keywords: GOLD classification, COPD, mortality, prognosi

Respiratory parameters predict poor outcome in COPD patients, category GOLD 2017 B

Kristian Brat,1 Marek Plutinsky,1 Karel Hejduk,2 Michal Svoboda,2 Patrice Popelkova,3 Jaromir Zatloukal,4 Eva Volakova,4 Miroslava Fecaninova,5 Lucie Heribanova,6 Vladimir Koblizek7 1Department of Respiratory Diseases, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czech Republic; 2Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic; 3Pulmonary Department, University Hospital, Ostrava, Czech Republic; 4Pulmonary Department, University Hospital, Olomouc, Czech Republic; 5Department of Pneumology, Bulovka Hospital, Prague, Czech Republic; 6Department of Respiratory Medicine, Thomayer Hospital, Prague, Czech Republic; 7Pulmonary Department, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czech Republic Background: Respiratory parameters are important predictors of prognosis in the COPD population. Global Initiative for Obstructive Lung Disease (GOLD) 2017 Update resulted in a vertical shift of patients across COPD categories, with category B being the most populous and clinically heterogeneous. The aim of our study was to investigate whether respiratory parameters might be associated with increased all-cause mortality within GOLD category B patients. Methods: The data were extracted from the Czech Multicentre Research Database, a prospective, noninterventional multicenter study of COPD patients. Kaplan–Meier survival analyses were performed at different levels of respiratory parameters (partial pressure of oxygen in arterial blood [PaO2], partial pressure of arterial carbon dioxide [PaCO2] and greatest decrease of basal peripheral capillary oxygen saturation during 6-minute walking test [6-MWT]). Univariate analyses using the Cox proportional hazard model and multivariate analyses were used to identify risk factors for mortality in hypoxemic and hypercapnic individuals with COPD. Results: All-cause mortality in the cohort at 3 years of prospective follow-up reached 18.4%. Chronic hypoxemia (PaO2 <7.3 kPa), hypercapnia (PaCO2 >7.0 kPa) and oxygen desaturation during the 6-MWT were predictors of long-term mortality in COPD patients with forced expiratory volume in 1 second ≤60% for the overall cohort and for GOLD B category patients. Univariate analyses confirmed the association among decreased oxemia (<7.3 kPa), increased capnemia (>7.0 kPa), oxygen desaturation during 6-MWT and mortality in the studied groups of COPD subjects. Multivariate analysis identified PaO2 <7.3 kPa as a strong independent risk factor for mortality. Conclusion: Survival analyses showed significantly increased all-cause mortality in hypoxemic and hypercapnic GOLD B subjects. More important, PaO2 <7.3 kPa was the strongest risk factor, especially in category B patients. In contrast, the majority of the tested respiratory parameters did not show a difference in mortality in the GOLD category D cohort. Keywords: mortality, hypoxemia, hypercapnia, COPD, GOLD 2017 updat