Background:
Women with angina pectoris, a positive exercise ECG for myocardial ischaemia and angiographically smooth coronary arteries (Cardiac Syndrome X), suffer increased psychological morbidity, debilitating symptomology and a poor quality of life. Autogenic Training (AT), a hypnosis-based auto-suggestive relaxation technique improved anxiety and quality of life in patients with CHD, multiple sclerosis and breast cancer. An exploration of AT as a treatment for Syndrome X was therefore undertaken.
Methods:
Fifty three female Syndrome X patients (mean ± SD; 57.4 ± 8.0 yrs) were randomised to an 8-week group-based AT and symptom diary program or symptom diary only control. Weekly group AT sessions were supported by an individual home program. The Hospital Anxiety and Depression Scale (HADS) Spielberger State-Trait Anxiety Inventory (STAI) Cardiac Anxiety Questionnaire (CAQ) and the Ferrans & Powers Quality of Life Index (QLI) were completed pre- and post-intervention and at 8-week follow-up.
Results
: Post-intervention, AT patients had reduced symptom severity (2.08 ± 1.03 vs. 1.23 ± 1.36, p=0.02) and frequency (6.11 ± 3.17 vs. 1.66 ± 2.19, p<0.001) with improved severity (8.04 ± 10.08 vs. 1.66 ± 2.19, p<0.001) and a trend toward reduced symptom frequency (1.95 ± 1.19 vs. 1.23 ± 1.36, p=0.063) compared to controls. Following AT, improved QLI health functioning (17.80 ± 5.74 vs. 19.41 ± 5.19, p=0.04) and CAQ fear (1.53 ± 0.61 vs. 1.35 ± 0.56, p=0.02) were found, with improvements in QLI health functioning (17.80 ± 5.74 vs. 20.09 ± 5.47, p=0.01), CAQ fear (1.53 ± 0.61 vs. 1.30 ± 0.67, p=0.002) CAQ total (1.42 ± 0.54 vs. 1.29 ± 0.475, p=0.04), STAI trait anxiety (42.95 ± 11.19 vs. 38.68 ± 11.47, p=0.01) and QLI quality of life (20.67 ± 5.37 vs. 21.9 ± 4.89, p=0.02) at follow-up. Post-monitoring changes in HADS depression (5.1 ± 3.3 vs. 4.2 ± 3.2, p=0.01), total HADS (13.95 ± 6.84 vs. 12.22 ± 5.75, p=0.02), CAQ avoidance (1.51 ± 0.92 vs. 1.24 ± 0.89, p=0.03), attention (1.33 ± 0.78 vs. 1.16 ± 0.57. p=0.05) and CAQ total (1.39 ± 0.6 vs. 1.23 ± 0.52, p=0.01) were shown in the control group. None were maintained at follow-up.
Conclusion
: An 8-week AT program has been shown to improve symptom severity and frequency, psychological morbidity and quality of life in women with Cardiac Syndrome X.
Cardiac syndrome X a challenge for Cardiologist