Célkitűzés: A koszorúér-betegség kialakulására és lefolyására jelentős, több útvonalon közvetített hatást gyakorol a szorongás és a depresszió. E pszichés állapotok befolyásoló tényezőire és kezelésére így kiemelt figyelmet szükséges fordítani. Egy lehetséges befolyásoló tényező az egyén betegségéről alkotott képe, az ún. betegségreprezentációja, amelynek feltárása az egyén meggyőződései között így központi fontosságú. Jelen kutatás célja koszorúér-áthidaló műtéten átesett betegek szorongásos és depresszív tüneteinek nyomonkövetése a beavatkozást követő fél éven belül, és a betegségreprezentáció ezen állapotokkal való lehetséges összefüggésének vizsgálata. Módszerek: A vizsgálatban 62, koszorúér-áthidaló műtéten (CABG) átesett személy (n=62; 40 férfi, 22 nő; átlagéletkor = 62,26, SD = 5,75) vett részt, akik a műtét miatti kórházi tartózkodás idején, majd kettő és hat hónappal később töltötték ki a Kórházi Szorongás és Depresszió Skálát (HADS), valamint a Betegségpercepció Kérdőív rövidített változatát (IPQ-R). Eredmények: Az eredmények szerint a bypass-műtött betegek szorongása a műtéti beavatkozást követő fél évben fokozatosan, statisztikailag jelentős mértékben csökkent (c2 [2]=34,718; p<0,001). A depresszív tünetek szintén szignifikáns mértékben mérséklődtek a beavatkozást követő két hónapban (Z= –2,353, p<0,05), azonban ezt követően emelkedett a tünetek mennyisége és intenzitása, noha nem szignifikáns mértékben (Z= –1,633, p=0,103). Az elemzés rámutatott továbbá, hogy a betegségreprezentáció Következmények, Időtartam és Identitás dimenziója szorosan ös - szefügg a fenti mutatókkal. Következtetések: Noha a CABG-n átesett beteg személyek által tapasztalt szorongásos tünetek mérséklődése a pszichés alkalmazkodás sikerességére utal, a depresszív tünetek számának fokozódása a betegek hangulati jellemzőinek adekvát szűrését, és indokolt esetben a betegek pszichológiai intervencióba való bevonásának szükségességét implikálja. Az eredmények továbbá azt sugallják, hogy az adekvátabb betegségreprezentáció kialakítása – különösen a betegség időtartamára, rövid és hosszú távú következményeire és tüneteire vonatkozóan – hatékonyan vezethet el a szorongásos és depresszív tünetek oldódásához. E betegségreprezentációk sikerrel módosíthatók, az esetleges téves percepciók adaptív és adekvát betegségképpé alakíthatók, akár a kezelőorvos által nyújtott szóbeli, illetve írásbeli tájékoztatás, betegoktatás eredményeként is.

Physical activity (PA) plays a crucial role in the management of coronary artery disease (CAD). The Health Action Process Approach provides a useful framework for understanding and predicting the process of health behaviors. The aim of the current study was to unveil the role of received social support in the HAPA model, concerning the physical activity of CAD patients. A longitudinal sample of 117 CAD patients filled out a questionnaire during three measurement points (baseline, 2 months, and 6 months later). The constructs within the model were measured by the previously validated HAPA scales. PA was assessed with four items, which were also included in the HAPA questionnaire. To test the direct and indirect associations between the variables, structural equation modeling with latent variables was employed. Received social support was proven to have a significant and strong effect on both action planning and action control, suggesting a synergistic effect on the individual factors, as well as increasing the explained variance of PA. Results confirmed the important role of received social support in the PA of CAD patients. It could be presumed that strengthening the social support from family and friends could support the regular physical activity of CAD patients.

Objective: Regular physical activity plays an important role as a protective factor in the treatment of coronary artery disease. Therefore, understanding the psychosocial factors that are involved in the process of changing and maintaining physical activity in the long term is fundamental in supporting patients’ lifestyle changes. The Health Action Process Approach (HAPA) health behavior model provides a practical, theoretically grounded, and empirically validated conceptual framework for understanding and predicting these factors. The present study aims to explore the factors involved in the process of physical activity of persons with coronary artery disease. Methods: The present longitudinal study included 117 patients with coronary artery disease (n = 117; 77 men, 40 women; mean age = 62.48 ± 6.22) who underwent CABG or PCI for the first time. At three measurement points, we examined the factors of the HAPA model and the physical activity of the patients. The test the direct and indirect associations of the variables structural equations modeling with latent variables was applied. Results: In the formation of behavioral intention the positive outcome expectancies proved to be an important factor. In translating intention into behavior, the constructs of planning, self-efficacy regarding the actual behavior, self-monitoring, and social support seemed to have significant roles. Together, the variables included in the present model explained 41% of the variance of physical activity. Conclusions: The results draw attention to the role of expectations about the positive consequences of physical activity as well as the importance of planning, self-efficacy, self-monitoring, and social support, which thus can be important factors in supporting patients with coronary artery disease to change their exercise habits in the long run. By incorporating these factors into the psychosocial intervention of patients, it is reasonable to expect that regular exercise habits formed during cardiological rehabilitation can persist in the long term.

Dietary behaviour plays a crucial role in both the onset and the management of coronary artery disease (CAD). To develop effective interventions to modify dietary behaviours of patients, it is fundamental to identify and examine the predictive factors that are relevant to healthy dietary behaviour. The Health Action Process Approach provides a useful framework for understanding and predicting the process of health behaviour. The aim of the current study is to clarify the role and effect of received social support in the HAPA model. A longitudinal sample of 117 CAD patients filled out a questionnaire at three time points. Along with HAPA constructs, dietary behaviour was assessed with a food frequency questionnaire. To investigate the longitudinal associations of the constructs, structural equation modelling with latent variables was employed. In the final model, outcome expectancies and pre-action self-efficacy jointly predicted behavioural intention. In the post-intentional phase, social support served as a mediator between intention and action planning. Moreover, coping planning mediated the relationship between action planning and dietary behaviour. These results confirmed the mediator role of social support in the intention-behaviour relationship. This finding suggests that social support can be a crucial component to facilitate healthy dietary behaviour.

A 45-year-old man was referred for urgent coronary angiography due to recent onset chest pain and ST-segment elevations. Cardiac enzyme levels were slightly elevated. Coronary angiography showed normal coronaries but revealed a thin, pointed radiopaque object in the projection of the right ventricle moving synchronously with cardiac contractions ( Panels A and …

OBJECTIVE:Leukocyte activation is thought to be responsible for the adverse effects and postoperative complications following cardiopulmonary bypass (CPB). A novel cell surface molecule, CD97, is a sensitive marker of leukocyte and primary lymphocyte activation. The present study aimed to determine the activation of different leukocyte subsets by comparing the expression of CD97 and adhesion molecules (CD11, CD18) in patients receiving coronary surgery with or without CPB.METHODS:30 patients were enrolled and scheduled for coronary bypass surgery under CPB (20 patients, group A) and with off-pump (OP) operation (10 patients, group B). Blood samples were taken before and during surgery, and over the following first week.RESULTS:Here, we report an early decrease in CD97 expression of granulocytes (PMN) and monocytes (MC) followed by an intensive increase reaching the maximum on postoperative days 2 and 3 in patients operated with CPB. The rate of active CD97-positive lymphocytes showed a marked, gradual increase until postoperative day 3 and remained elevated up to day 7 after CPB. OP surgery resulted in moderate alteration in the presence of CD97 on PMN, MC and lymphocytes. The expression of adhesion molecules was similar to CD97 in all leukocyte subsets.CONCLUSION:The findings about CD97 expression suggest considerable leukocyte activation following coronary bypass with CPB compared to OP surgery. The collected data show that the lymphocytes are highly activated and involved in leukocyte sequestration after CPB. Moreover, the importance of CD97 in CPB-related inflammatory response can be stated.