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Psychosocial and psychophysiological characteristics of atrial fibrillation patients and their influence on the prothrombotic state and prognosis

Thrall, Graham (2006)
Ph.D. thesis, University of Birmingham.

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Abstract

The purpose of this thesis was to (1) examine the psychological morbidity associated with atrial fibrillation (AF), and (2) determine the effects of acute mental and postural stress, and hydration status on indices haemorhelogy, endothelial function, and platelet reactivity. Symptoms of depression (BDI scores > 10) persisted in 38% of patients with AF, with elevated state and trait anxiety (STAI score >40) being reported in 28% and 38% of patients, respectively. No significant differences in depression, state anxiety, and QoL were observed between AF and hypertensive patients; however, AF patients displayed higher levels of trait anxiety. Multiple regression analysis demonstrated baseline depression scores provided the best independent prediction of future QoL. Acute mental and postural stress yielded significant changes in haemodynamics and haemorhelogy, in addition to increasing biomarkers of endothelial dysfunction and platelet reactivity. Increased hydration status reduced blood pressure and markers of endothelial perturbation and platelet morphology both at rest and in response to the stress tasks. In conclusion, AF patients display comparable levels of depression and anxiety to patients following a myocardial infarction. In addition, behavioural activities such as mental and postural stress may implicated in the pathogenesis of acute coronary syndromes through the development of a prothrombotic state.

Type of Work:Ph.D. thesis.
School/Faculty:Faculties (to 1997) > Faculty of Science
Department:Sport & Exercise Sciences
Additional Information:

Appendix I is not available in this web version. Appendix II is a published paper: Graham Thrall, Deirdre Lane, Douglas Carroll, Gregory Y.H. Lip, Quality of Life in Patients with Atrial Fibrillation: A Systematic Review, The American Journal of Medicine, Volume 119, Issue 5, May 2006, Pages 448.e1-448.e19, ISSN 0002-9343, http://dx.doi.org/DOI:10.1016/j.amjmed.2005.10.057

Keywords:Atrial fibrillation; Rate and rhythm-control interventions; Quality of life
Subjects:R Medicine (General)
RC1200 Sports Medicine
Institution:University of Birmingham
Library Catalogue:Check for printed version of this thesis
ID Code:246
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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