Abstract
Background and Objectives: The autonomic nervous system (ANS) is involved in panic disorders. ANS dysfunction has been shown to be associated with ventricular arrhythmia and increased heterogeneity of ventricular repolarization. However, there remains limited evidence of the relationship between panic disorders and ventricular depolarization markers, including the Tp-e interval and Tp-e/QT ratio. This study aimed to evaluate ventricular repolarization parameters in patients with panic disorder. Materials and Methods: In total, 40 patients with panic disorder, diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, were included in the study group. The control group comprised of 50 age- and sex-matched healthy individuals. A standard 12 lead electrocardiogram was recorded on all participants, and heart rate, QT interval, QRS duration, Tp-e interval, and Tp-e/QT ratio were measured. Results: QRS durations and QT intervals were similar in the study and control groups. Compared to the control group, QTd, Tp-e, and cTp-e intervals as well as Tp-e/QT and Tp-e/QTc ratios were significantly increased in patients with panic disorder (p < 0.05 for all). In the study group, the Severity Measure for Panic Disorder—Adult score had a significant positive correlation with the Tp-e interval (r = 0.369, p < 0001), cTp-e interval (r = 0.531, p < 0.001), Tp-e/QT ratio (r = 0.358, p = 0.001), and Tp-e/QTc ratio (r = 0.351, p = 0.001). Conclusion: These findings indicate that panic disorders are associated with increased ventricular repolarization heterogeneity, which may be attributed to ANS dysregulation.
Highlights
Patients frequently present with non-cardiac chest pain and palpitations in cardiology outpatient clinics
The mean heart rate was 80.2 ± 13.6 bpm compared to 73.7 ± 11.2 bpm in the control group (p = 0.017)
The QT dispersion (QTd) and corrected QTd (cQTd) intervals were significantly higher in the study group than in the control group (p < 0.05 for both)
Summary
Patients frequently present with non-cardiac chest pain and palpitations in cardiology outpatient clinics. Of patients with non-cardiac chest pain and palpitations, 72% have a coexisting mental illness. Patients with non-cardiac chest pain are susceptible to experiencing panic attacks and developing panic disorders [2]. It is well established that the ANS is involved in panic disorders Symptoms such as chest pain, palpitations, sweating, breathing difficulties, feelings of suffocation, and hot flashes are common symptoms of panic attacks and indicate ANS dysfunction [4]. This study aimed to evaluate ventricular repolarization parameters in patients with panic disorder. Results: QRS durations and QT intervals were similar in the study and control groups. Compared to the control group, QTd, Tp-e, and cTp-e intervals as well as Tp-e/QT and Tp-e/QTc ratios were significantly increased in patients with panic disorder (p < 0.05 for all).
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