Clinical characteristics and level of anxiety in patients with heart failure depending of social and household stressogenic factors associated with martial law

Abstract

The aim – to study the impact of potential stressogenic factors associated with martial law on basic clinical and instrumental parameters and the severity of anxiety symptoms in patients with chronic heart failure (CHF).
Materials and methods. 200 patients with CHF of NYHA II-IV functional classes were examined, which had treatment at the cardiological department. The diagnosis of heart failure was determined according to the recommendations of the European Society of Cardiology in 2021 with the involvement of indicators of general clinical examination, electrocardiography, echocardiography, and laboratory tests. Patients were given a standardized survey of two questionnaires, namely, the original General Burden of Martial Law questionnaire and the standard HADS anxiety/depression questionnaire.
Results and discussion. The high level of anxiety, which corresponded to clinically significant (≥ 11 points on the HADS scale) in those patients who were exposed to various potentially stressful influences (internally displaced persons, separation from family, absence of medical care and/or medicines). The period of long-term absence of medical care was also associated with a statistically significantly higher level of C-reactive protein and a statistically significantly lower relative number of lymphocytes in the blood compared to other patients. Patients without medicines had a higher level of anxiety and a lower (at the limit of statistical significance) relative number of lymphocytes in the blood. The original ABVS scale can use in patients with psychological problems. The main clinical and instrumental indicators of patients was not depended of potentially stressful factors.
Conclusions. Internally displaced persons with CHF had a statistically significantly higher sum of points of War Impact Questionnaire (ABVS) compared to other patients with CHF (p<0.0001). Patients from a combat zone, as well as patients who were separated from their relatives for a long time, had a high level of anxiety compared to other patients. Patients with CHF without medical care were characterized by a high level of anxiety (12.0 points on the HADS scale against 8.0 in other patients, p=0.008), a statistically significantly higher level of C-reactive protein ((13.4±10.10) vs (8.6±11.6) mg/ml in other patients, p=0.03) and a lower relative content of lymphocytes in peripheral blood compared to other patients ((17.8±6.6) versus (21.0± 7.9), p=0.03).