Effects of anxiety and depression on the composition and properties of coronary plaque in patients with coronary heart disease

doi:10.3969/j.issn.1004-583X.2023.01.006

Abstract

Abstract:

Objective To investigate the effect of anxiety and depression on the composition and properties of coronary plaque in patients with coronary heart disease (CHD). Methods Totally 76 CHD patients underwent coronary angiography and virtual histology-intravascular ultrasound (VH-IVUS) in the Department I of cardiovasology, North China University of Science and Technology Affiliated Hospital from January 2021 to January 2022 were enrolled. The situation and degree of anxiety and depression were evaluated by the hospital anxiety and Depression Scale (HADS), including total anxiety and Depression Scale (HADS-t), anxiety subscale (HADS-a) and depression subscale (HADS-d). The proportion of each component in the plaque was measured by VH-IVUS technology, including the proportion of necrotic core (NC), dense calcium (DC), fibrous (FI) and fibro-fatty (FF), and whether the plaque was thin-cap fibroatheroma (TCFA). According to HADS scale, the patients were assigned to the control group, the simple anxiety group, the simple depression group, and the anxiety and depression group. The differences in the proportion of plaque components among the four groups were compared. Pearson correlation analysis was used to analyze the correlation between HADS score and various components of plaque. Results The proportion of necrotic core in the anxiety and depression group significantly was significantly higher than that in the control group, the simple anxiety group and the simple depression group ( $P$ <0.01). The proportion of TCFA in the simple anxiety group, the simple depression group and the anxiety depression group was significantly higher than that in the control group ( $P$ <0.01). Pearson correlation analysis showed that HADS score was positively correlated with the proportion of necrotic tissue (HADS-a: $r$ =0.259, $P$ =0.025; HADS-d: $r$ =0.299, $P$ =0.009; HADS-t: $r$ =0.302, $P$ =0.008, respectively). Conclusion CHD patients with anxiety and depression have more necrotic components in coronary plaque and stronger vulnerability.

Key words: coronary disease, adverse emotions, visual histology, endosonography

CLC Number:

R541.4

Yi Xin, Liu Canzhang, Liu Qiang, Wang Cong, Gao Teng, Yan Jie. Effects of anxiety and depression on the composition and properties of coronary plaque in patients with coronary heart disease[J]. Clinical Focus, 2023, 38(1): 50-54.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.01.006

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I1/50

Figures/Tables 7

Tab. 1 Comparison of general data of four groups

项目	对照组 ( $n$ =20)	单纯焦虑组 ( $n$ =11)	单纯抑郁组 ( $n$ =12)	焦虑抑郁组 ( $n$ =33)	统计值	$P$ 值
年龄(岁)	59.45±8.49	56.36±10.86	63.00±11.74	58.36±11.24	0.845	0.474
男/女(例)	12/8	8/3	8/4	22/11	0.548	0.908
吸烟[例(%)]	8(40.0)	5(45.6)	3(25)	9(27)	2.055	0.561
饮酒[例(%)]	7(35.00)	4(36.7)	3(25.0)	13(39.4)	0.802	0.849
高血压[例(%)]	12(60.0)	5(45.6)	6(50.0)	14(42.4)	1.597	0.660
糖尿病[例(%)]	7(35.0)	5(45.6)	4(33.3)	12(36.4)	0.447	0.932
BMI(kg/cm²)	26.13±3.61	27.44±10.88	24.23±2.77	26.18±3.38	0.788	0.504
LAD(例)	6	3	2	9	0.737	0.848
LCX(例)	2	1	1	6	1.307	0.471
RCA(例)	2	1	2	3	0.583	0.730
LAD+LCX(例)	3	2	2	2	1.939	0.849
LAD+RCA(例)	1	1	3	2	4.393	0.222
LCX+RCA(例)	2	1	1	4	0.180	0.981
LAC+LCX+RCA(例)	4	2	1	7	0.017	0.789

Tab. 1 Comparison of general data of four groups

项目	对照组 ( $n$ =20)	单纯焦虑组 ( $n$ =11)	单纯抑郁组 ( $n$ =12)	焦虑抑郁组 ( $n$ =33)	统计值	$P$ 值
年龄(岁)	59.45±8.49	56.36±10.86	63.00±11.74	58.36±11.24	0.845	0.474
男/女(例)	12/8	8/3	8/4	22/11	0.548	0.908
吸烟[例(%)]	8(40.0)	5(45.6)	3(25)	9(27)	2.055	0.561
饮酒[例(%)]	7(35.00)	4(36.7)	3(25.0)	13(39.4)	0.802	0.849
高血压[例(%)]	12(60.0)	5(45.6)	6(50.0)	14(42.4)	1.597	0.660
糖尿病[例(%)]	7(35.0)	5(45.6)	4(33.3)	12(36.4)	0.447	0.932
BMI(kg/cm²)	26.13±3.61	27.44±10.88	24.23±2.77	26.18±3.38	0.788	0.504
LAD(例)	6	3	2	9	0.737	0.848
LCX(例)	2	1	1	6	1.307	0.471
RCA(例)	2	1	2	3	0.583	0.730
LAD+LCX(例)	3	2	2	2	1.939	0.849
LAD+RCA(例)	1	1	3	2	4.393	0.222
LCX+RCA(例)	2	1	1	4	0.180	0.981
LAC+LCX+RCA(例)	4	2	1	7	0.017	0.789

Tab. 2 Comparison of plaque components of four groups(%)

组别	例数	NC占比	DC占比	FI占比	FF占比
对照组	20	8.84±7.48	0.8(0.25, 2.08)	62.15(50.35, 71.40)	28.58±14.33
单纯焦虑组	11	8.99±6.62	0.8(0.10,14.70)	56(47.90,66.10)	27.68±12.66
单纯抑郁组	12	8.45±5.83	1.5(0.20,4.98)	62.65(52.28,68.10)	30.43±11.94
焦虑抑郁组	33	15.77±6.81^*#△	3.1(0.70,7.90)	58.8(46.95,68.10)	21.67±10.69
$F$ / $Z$ 值		6.55	5.194	1.332	2.263
$P$ 值		0.001	0.158	0.722	0.088

Tab. 2 Comparison of plaque components of four groups(%)

组别	例数	NC占比	DC占比	FI占比	FF占比
对照组	20	8.84±7.48	0.8(0.25, 2.08)	62.15(50.35, 71.40)	28.58±14.33
单纯焦虑组	11	8.99±6.62	0.8(0.10,14.70)	56(47.90,66.10)	27.68±12.66
单纯抑郁组	12	8.45±5.83	1.5(0.20,4.98)	62.65(52.28,68.10)	30.43±11.94
焦虑抑郁组	33	15.77±6.81^*#△	3.1(0.70,7.90)	58.8(46.95,68.10)	21.67±10.69
$F$ / $Z$ 值		6.55	5.194	1.332	2.263
$P$ 值		0.001	0.158	0.722	0.088

Tab. 3 Comparison of plaque vulnerability of four groups (cases %)

组别	例数	TCFA
对照组	20	5(25.0)
单纯焦虑组	11	4(36.4)^*
单纯抑郁组	12	5(41.7)^*
焦虑抑郁组	33	26(78.9)^*
χ²值		16.927
$P$ 值		0.001

Tab. 3 Comparison of plaque vulnerability of four groups (cases %)

组别	例数	TCFA
对照组	20	5(25.0)
单纯焦虑组	11	4(36.4)^*
单纯抑郁组	12	5(41.7)^*
焦虑抑郁组	33	26(78.9)^*
χ²值		16.927
$P$ 值		0.001

Tab. 4 Correlation analysis between HADs score and plaque components

斑块成分	HAD-a评分		HADS-d评分		HADS-t评分
斑块成分	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值
NC占比	0.259	0.024	0.299	0.009	0.302	0.008
DC占比	0.072	0.539	-0.080	0.493	-0.002	0.986
FI占比	-0.056	0.632	-0.047	0.689	-0.056	0.633
FF占比	-0.198	0.086	-0.141	0.223	-0.185	0.110

Tab. 4 Correlation analysis between HADs score and plaque components

斑块成分	HAD-a评分		HADS-d评分		HADS-t评分
斑块成分	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值
NC占比	0.259	0.024	0.299	0.009	0.302	0.008
DC占比	0.072	0.539	-0.080	0.493	-0.002	0.986
FI占比	-0.056	0.632	-0.047	0.689	-0.056	0.633
FF占比	-0.198	0.086	-0.141	0.223	-0.185	0.110

Fig. 1 Scatter plot of HADS-a score and plaque composition

Fig. 2 Scatter plot of HADS-d score and plaque composition

Fig. 3 Scatter plot of HADS-t score and plaque composition

References 14

[1]	周晓美, 高进, 訾希存. 经皮冠状动脉介入术后患者抑郁情绪相关因素的系统综述[J]. 中国心理卫生杂志, 2020, 34(11):898-902.
[2]	血管内超声在冠状动脉疾病中应用的中国专家共识专家组. 血管内超声在冠状动脉疾病中应用的中国专家共识(2018)[J]. 中华心血管病杂志, 2018, 46(5):344-351.
[3]	辛若丹, 李文森, 管考华, 等. 焦虑抑郁障碍与冠心病的相关性[J]. 中国老年学杂志, 2017, 37(6):1556-1559.
[4]	应优优, 李浙成, 胡智星, 等. 焦虑抑郁与冠心病发生的关系研究[J]. 中华老年心脑血管病杂志, 2015, 17(7):762-763.
[5]	徐振东, 张琳, 张胜利, 等. 冠心病患者血清脂蛋白(a)和胱抑素C与抑郁症的关系[J]. 心脏杂志, 2021, 33(6): 624-627.
[6]	蒋守涛, 吴永刚, 王锐, 等. 焦虑抑郁障碍老年冠心病患者血清CA153、TNF-α表达水平的影响及临床意义[J]. 临床和实验医学杂志, 2021, 20(17):1831-1834.
[7]	胡大一. 从“双心医学”到“五大处方”[J]. 中华心血管病杂志, 2021, 49(11):1061-1062.
[8]	连延华, 杨建涛. 合并抑郁对冠心病患者的炎症反应及内皮功能的影响[J]. 国际精神病学杂志, 2021, 48(4):693-696.
[9]	Kemp AH, Brunoni AR, Santos IS, et al. Effects of depression, anxiety, comorbidity, and antidepressants on resting-state heart rate and its variability: An ELSA-Brasil cohort baseline study[J]. Am J Psychiatry, 2014, 171(12):1328-1334. doi: 10.1176/appi.ajp.2014.13121605 URL
[10]	刘安邦, 马欢, 耿庆山. 冠心病合并抑郁症的研究进展[J]. 中国临床新医学, 2021, 14(2):205-209.
[11]	Carney RM, Freedland KE. Depression and coronary heart disease[J]. Nat Rev Cardiol, 2017, 14(3):145-155. doi: 10.1038/nrcardio.2016.181 pmid: 27853162
[12]	樊建芳, 武云涛, 张红云, 等. 焦虑抑郁情绪对冠心病患者血管内皮细胞功能的影响[J]. 中国临床保健杂志, 2019, 22(5):609-611.
[13]	Timmins LH, Suo J, Eshtehardi P, et al. Comparison of angiographic and IVUS derived coronary geometric reconstructions for evaluation of the association of hemodynamics with coronary artery disease progression[J]. Int J Cardiovasc Imaging, 2016, 32(9):1327-1336. pmid: 27229349
[14]	Libby P, Okamoto Y, Rocha VZ, et al. Inflammation in atherosclerosis: Transition from theory to practice[J]. Circ J, 2010, 74(2):213-220. pmid: 20065609

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