STATE-TRAIT ANXIETY AS PSYCHOLOGICAL MEDIATOR AMONG BASELINE SYMPATHOVAGAL BALANCE AND CARDIOVASCULAR REHABILITATION OUTCOMES
Compare, A. and Molinari, E., Catholic University of Milan and Clinical Psychology Service and Luca, G., Istituto Auxologico Italiano, Italy
Anxiety may be a potential risk factor for subsequent cardiac relapse. The impact of anxiety on cardiovascular rehabilitation has been suggested to depend on sympathovagal balance conditions. This study examined the potential mediation role of the baseline anxiety level in the relation among baseline sympathovagal balance and cardiovascular rehabilitation outcomes. A sample of 158 inpatients (101 men and 57 women; age = 59.55, SD = 8.57; BMI = 38,97, SD = 7,32) was evaluated before and at the end of the cardiovascular rehabilitation program (CRP). The CRP was conducted on the base of the International Guidelines. Anxiety level was evaluated by State- Trait Anxiety Inventory (STAI). Sympathovagal balance was evaluated by using power spectral analysis by LF/HF value. The cardiovascular rehabilitations outcomes were: arterial pressure (AP), cardiac frequency (CF), measured at rest and at the peak effort during exercise stress test , and METs. Statistical analysis was conduct by Logistic Regression Model (LRM). In the compute of the LRM, LF/HF is considerate like continuous variable while baseline state-trait anxiety and cardiovascular rehabilitation outcomes was, on the base of median cut-off values, dichotomized. Odds ratio put in evidence that in the LF/HF-METs outcome relationship the high trait-anxiety (p<05; OR = 11.92) and the high state- anxiety (p<05; OR = 7.81) reduce the percentage of high outcome and improve the percentage of low outcome. While in the LF/HF-PAmax outcome relation the low trait-anxiety (p<01; OR = 14.39) and the low state- anxiety (p<01; OR = 8.66) reduce the percentage of low outcome and improve the percentage of high outcome. Anxiety state and trait have a potential mediator role in the relationship between baseline sympathovagal balance and cardiovascular rehabilitation outcomes for some cardiovascular variables. The results are discuss deepening the anxiety role in cardiac rehabilitation.