Association of positive well-being with reduced cardiac repolarization abnormalities in the First National Health and Nutrition Examination Survey

• Type of Material: Article
• Authors: Nino Isakadze, Emory University; Elsayed Z. Soliman, Wake Forest University; Viola Vaccarino, Emory University; William Whang, Mt Sinai Medical Center; Rachel Lampert, Yale University; J. Douglas Bremner, Emory University; Amit J. Shah, Emory University
• Language: English
• Date: 2018-08-15
• Publisher: ELSEVIER IRELAND LTD
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Published by Elsevier B.V. CC BY NC ND 4.0
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ijcard.2018.04.135
• Title of Journal or Parent Work: International Journal of Cardiology
• Volume: 265
• Start Page: 246
• End Page: 250
• Grant/Funding Information: This work was supported by the National Institutes of Health [UL1TR000454] as part of the Clinical and Translational Science Award program; and KL2TR000455 as part of the Emory University KL2 scholarship.; Also Dr. Shah was sponsored by the NIH/NHLBI, K23 HL127251.; Additional support was received from the American Heart Association [15SDG25310017].
• Keywords: Cardiovascular System & Cardiology; Psychological well-being; DEPRESSION; Cardiac & Cardiovascular Systems; DEATH; ANXIETY; AXIS DEVIATION; RISK-FACTOR; CORONARY-HEART-DISEASE; ARRHYTHMIAS; CARDIOVASCULAR-DISEASE; T-WAVE ALTERNANS; Science & Technology; STRESS; Cardiac repolarization; Coronary heart disease; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery

Abstract

Background: The mechanisms by which psychological factors may influence possibly arrhythmia risk are not known. We hypothesized that psychological wellness, measured by the General Well-Being Schedule (GBWS), is associated with less repolarization heterogeneity as measured by T-axis. We also explored whether T-axis was a mediator in the relationship of GWBS with adverse cardiac outcomes. Methods: We studied 5533 adults aged 25–74 years without a history of CVD from NHANES I (National Health and Nutrition Examination Survey) (1971–75). Frontal T-axis was obtained through 12-lead ECG and characterized as normal (15° to 75°), borderline (−15° to 15° or 75° to 105°) or abnormal (>105° or <−15°). Results: The mean ± SD age was 43.1 ± 11.5 years and 55% were women. A 1-SD increase in GWBS score associated with a 23% reduced odds of abnormal T-axis (p < 0.001) and 11% lower hazard of composite CHD hospitalization and death (p = 0.02). When adjusting for sociodemographic factors, health behaviors, and CHD risk factors, the association was minimally changed and remained statistically significant. Additional adjustment for T-axis did not change the relationship with outcomes. Conclusion: General well-being is independently associated with less abnormal frontal T-axis and CHD events in otherwise healthy individuals.