Comparison of Frontal QRS-T Angle in Patients with Panic Disorder and Healthy Control Group: A Preliminary Study

Psychiatry and Clinical Psychopharmacology(2023)

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Abstract
Background:Autonomic instability is blamed for panic disorder pathophysiology. It has been suggested that this may raise the risk of cardiovascular disease. A new proposal for ventricular depolarization and repolarization impairment is the frontal QRS-T angle. Methods:In this cross-sectional study, 61 patients with panic disorder and 73 healthy controls were included. The severity of panic disorder was evaluated using the Severity Measure for Panic Disorder-Adult. Electrocardiography, echocardiography, hemogram, and biochemistry data were recorded. Results:Patients with panic disorder had a greater frontal QRS-T angle than healthy controls. In panic disorder patients, the values for hemoglobin, eosinophil count, and high-density lipoprotein cholesterol were all significantly lower than healthy controls. In comparison to healthy controls, panic disorder patients had significantly higher values for total cholesterol, fasting triglycerides, low-density lipoprotein cholesterol, platelet-to-lymphocyte ratio, and monocyte-to-high-density lipoprotein cholesterol ratio. Significant correlations were found between frontal QRS-T and Severity Measure for Panic Disorder-Adult, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. The frontal QRS-T value is positively and significantly predicted by the neutrophil-to-lymphocyte ratio value according to the linear regression analysis for the frontal QRS-T angle [F(6.54) = 8.375, P < .001, adjusted R 2: 0.424]. Conclusion:The current study found that the frontal QRS-T angle increased with the severity of the disease in patients with panic disorder. Frontal QRS-T angle may help to estimate cardiovascular disease risk in patients with panic disorder. This relationship may be necessary in terms of cardiovascular events and inflammatory conditions.
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