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Carpenter JS, Fagan R, Alzahrani M, Jaynes HA, Tisdale JE, Kovacs RJ, Chen CX, Draucker CB. "Quick flutter skip": midlife women's descriptions of palpitations. Menopause 2023; 30:1014-1021. [PMID: 37643379 PMCID: PMC10581607 DOI: 10.1097/gme.0000000000002244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The objective of this study is to describe peri- and postmenopausal women's experiences of palpitations (quality, frequency, severity, distress, duration and temporal pattern, aura, associated symptoms, and aggravating/alleviating factors) and related healthcare experiences. METHODS Qualitative descriptive methods were used. Semistructured interviews were conducted with women who reported palpitations and were enrolled in a larger case-control pilot study comparing electrocardiographic results between women with and without palpitations. Authors analyzed women's narratives using standard content analytic procedures. RESULTS Fourteen participants (mean age, 54.5 y [SD = 4.8 y]; range, 46-62 y; 79% postmenopausal) completed interviews. The interviews revealed that women (a) often had difficulty describing their palpitations until prompted by the interviewer; (b) experienced noteworthy variations in the quality and other dimensions of their palpitations; (c) had a wide variety of healthcare experiences related to their palpitations, including not reporting their symptoms to providers, having providers dismiss their symptoms, and having providers be aware of their symptoms and provide diagnostic tests; and (d) at times, created worst case scenarios (downward shifts) under which they would seek treatment for their palpitations, thus enabling them to minimize their symptoms and avoid healthcare. CONCLUSION This study advances understanding of how women describe their palpitations and related healthcare experiences. Findings could have implications for building research and clinical tools to guide assessment, communication, and/or education for patients and/or providers about palpitations and for developing and testing behavioral interventions to address this poorly understood symptom in peri- and postmenopausal women.
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Affiliation(s)
| | - Rileigh Fagan
- Indiana University School of Nursing, Indianapolis, IN, 46202
| | | | | | - James E. Tisdale
- Purdue University College of Pharmacy, West Lafayette, IN
- Indiana University School of Medicine, Indianapolis, IN
| | | | - Chen X. Chen
- Indiana University School of Nursing, Indianapolis, IN, 46202
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Sheng Y, Carpenter JS, Paul SM, Conley YP, Levine JD, Miaskowski C. Patients with palpitations experience a higher symptom burden prior to breast cancer surgery. Eur J Oncol Nurs 2023; 65:102341. [PMID: 37327556 DOI: 10.1016/j.ejon.2023.102341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/11/2023] [Accepted: 04/29/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Anxiety, depression, sleep disturbance, fatigue, cognitive dysfunction, and pain are common symptoms reported by patients with breast cancer. Recent evidence suggests that palpitations, a feeling of the heart racing or pounding, may be equally common. Study purpose was to compare the severity and clinically meaningful occurrence rates of common symptoms and quality of life (QOL) outcomes between patients with breast cancer who did and did not report palpitations prior to surgery. METHODS Patients (n = 398) were classified as having or not having palpitations using a single item from the Menopausal Symptoms Scale. Valid and reliable measures were used to assess state and trait anxiety, depression, sleep disturbance, fatigue, energy, cognitive function, breast symptoms, and QOL. Between group differences were evaluated using parametric and non-parametric tests. RESULTS Patients with palpitations (15.1%) reported significantly higher severity scores for state and trait anxiety, depression, sleep disturbance, and fatigue as well as significant decrements in energy and cognitive function (all p < .05). A higher percentage of these patients had clinically meaningful levels of state anxiety, depression, sleep disturbance and decrements in cognitive function (all p < .05). Except for spiritual well-being, QOL scores were lower in the palpitations group (all p < .001). CONCLUSION Findings support the need for routine assessment of palpitations and management of multiple symptoms in women prior to breast cancer surgery.
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Affiliation(s)
- Ying Sheng
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | | | - Steven M Paul
- School of Nursing, University of California at San Francisco, San Francisco, CA, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jon D Levine
- School of Medicine, University of California at San Francisco, San Francisco, CA, USA
| | - Christine Miaskowski
- School of Nursing, University of California at San Francisco, San Francisco, CA, USA; School of Medicine, University of California at San Francisco, San Francisco, CA, USA.
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3
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Sheng Y, Carpenter JS, Smith BJ, Paul SM, Melisko M, Moslehi J, Levine JD, Conley YP, Kober KM, Miaskowski C. A Pilot Study of Associations Between the Occurrence of Palpitations and Cytokine Gene Variations in Women Prior to Breast Cancer Surgery. Biol Res Nurs 2023; 25:289-299. [PMID: 36255356 PMCID: PMC10236444 DOI: 10.1177/10998004221134684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Palpitations are common and have a negative impact on women's quality of life. While evidence suggests that inflammatory mechanisms may play a role in the development of palpitations, no studies have evaluated for this association in patients with breast cancer who report palpitations prior to surgery. The purpose of this pilot study was to evaluate for associations between the occurrence of palpitations and single nucleotide polymorphisms (SNPs) in genes for pro- and anti-inflammatory cytokines, their receptors, and transcriptional regulators. METHODS Patients were recruited prior to surgery and completed a self-report questionnaire on the occurrence of palpitations. Genotyping of SNPs in cytokine genes was performed using a custom array. Multiple logistic regression analyses were done to identify associations between the occurrence of palpitations and SNPs in fifteen candidate genes. RESULTS Of the 82 SNPs evaluated in the bivariate analyses, eleven SNPs in 6 genes were associated with the occurrence of palpitations. After controlling for functional status, the occurrence of back pain, and self-reported and genomic estimates of race/ethnicity, 3 SNPs in 3 different genes (i.e., interleukin (IL) 1-beta (IL1B) rs1143643, IL10 rs3024505, IL13 rs1295686) were associated with the occurrence of palpitations prior to surgery (all p ≤ .038). CONCLUSIONS While these preliminary findings warrant replication, they suggest that inflammatory mechanisms may contribute to the subjective sensation of palpitations in women prior to breast cancer surgery.
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Affiliation(s)
- Ying Sheng
- School of Nursing, Vanderbilt University,
Nashville, TN, USA
| | | | - Brenda J. Smith
- School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Steven M. Paul
- School of Nursing, University of California, San Francisco, CA, USA
| | - Michelle Melisko
- School of Nursing, University of California, San Francisco, CA, USA
| | - Javid Moslehi
- School of Nursing, University of California, San Francisco, CA, USA
| | - Jon D. Levine
- School of Nursing, University of California, San Francisco, CA, USA
| | - Yvette P. Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kord M. Kober
- School of Nursing, University of California, San Francisco, CA, USA
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Carpenter JS, Cortés YI, Tisdale JE, Sheng Y, Jackson EA, Barinas-Mitchell E, Thurston RC. Palpitations across the menopause transition in SWAN: trajectories, characteristics, and associations with subclinical cardiovascular disease. Menopause 2023; 30:18-27. [PMID: 36256921 PMCID: PMC9797427 DOI: 10.1097/gme.0000000000002082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Our objectives were to identify trajectories of palpitations over the menopause transition, characterize them, and examine associations with subclinical cardiovascular disease (CVD). METHODS We analyzed the following data from the multisite, multiethnic SWAN (Study of Women Across the Nation): reported palpitations occurrence over time; baseline sociodemographic, reproductive, medication, and health-related factors; and follow-up visit subclinical CVD (carotid atherosclerosis, vascular stiffness). Trajectories of palpitations (n = 3,276), their characteristics, and their associations with subclinical CVD (n = 1,559) were identified using group-based trajectory modeling and linear and logistic regression models. RESULTS Three trajectories emerged: high probability of palpitations in perimenopause to early postmenopause diminishing in late postmenopause (15.9% of women), moderate probability of palpitations in perimenopause to early postmenopause diminishing in late postmenopause (34.3%), and sustained low probability of palpitations (49.8%). In the fully adjusted multivariable model, the high probability group had a more adverse reproductive and health-related profile at baseline (higher gravidity, early perimenopause, vasomotor symptoms, poorer overall health, higher depressive symptoms, higher perceived stress, greater sleep problems, higher blood pressure). In fully adjusted multivariable models, palpitation trajectories were not related to atherosclerosis or arterial stiffness. CONCLUSIONS Distinct patterns of palpitations emerged, with a substantial portion of women having palpitations during the perimenopause and early postmenopause. Palpitations were not associated with subclinical CVD. Findings can help identify women at risk of palpitations during the menopause transition who may need symptom relief.
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Affiliation(s)
| | - Yamnia I. Cortés
- University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - James E. Tisdale
- Purdue University College of Pharmacy, West Lafayette, IN 47907, USA
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Ying Sheng
- Indiana University School of Nursing, Indianapolis, IN 46202, USA
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Carpenter JS, Sheng Y, Pike C, Elomba CD, Alwine JS, Chen CX, Tisdale JE. Correlates of palpitations during menopause: A scoping review. Womens Health (Lond Engl) 2022; 18:17455057221112267. [PMID: 35833667 PMCID: PMC9289918 DOI: 10.1177/17455057221112267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: Palpitations during peri- and post-menopause are common. It is unclear what
variables are related to palpitations in peri- and post-menopausal women.
The purpose of this scoping review was to summarize potential correlates of
palpitations in women transitioning through menopause. Methods: The review followed the Preferred Reporting Items for Systematic reviews and
Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Authors included
English-language, full-length, peer-reviewed, cross-sectional research
articles on palpitations in menopausal women published through December 18,
2021, from PubMed, Cumulative Index to Nursing and Allied Health Literature
(CINAHL), and PsycINFO searches. Following de-duplication, screening of
titles and abstracts, and review of full-texts, independent reviewers
extracted data on variables studied in relationship to palpitations from 84
articles and resolved discrepancies. Authors extracted data on (1)
demographic, clinical, biomarker, and symptom/quality of life variables and
(2) data analysis method (bivariate, multivariate). Authors classified each
variable as a likely, unlikely, or unclear correlate of palpitations. Results: Articles were diverse in region of origin, sample sizes, and variables
assessed in relationship to palpitations. Evidence for any one variable was
sparse. Likely correlates of palpitations included race/ethnicity, lower
physical activity, worse vasomotor symptoms (VMSs), worse sleep, and worse
quality of life. Unlikely correlates included age, employment, education,
marital status, socioeconomic status, comorbidities, body mass index, and
sexual difficulties. Unclear correlates due to equivocal evidence were
menopausal status, smoking, and depression. Unclear correlates due to
insufficient evidence (less than three articles) included all of the
assessed biomarkers, anxiety, and stress. Conclusion: Likely correlates were identified including race/ethnicity, physical
activity, VMS, sleep, and quality of life. However, additional research is
needed to better understand potential correlates of palpitations.
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Affiliation(s)
| | - Ying Sheng
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Caitlin Pike
- University Library, Indiana University–Purdue University Indianapolis, Indianapolis, IN, USA
| | | | | | - Chen X Chen
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - James E Tisdale
- Purdue University College of Pharmacy, West Lafayette, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
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Carpenter JS, Tisdale JE, Larson JC, Sheng Y, Chen CX, Von Ah D, Kovacs R, Reed SD, Thurston RC, Guthrie KA. MsFLASH analysis of diurnal salivary cortisol and palpitations in peri- and postmenopausal women. Menopause 2021; 29:144-150. [PMID: 35084374 PMCID: PMC8797016 DOI: 10.1097/gme.0000000000001897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the relationship between diurnal salivary cortisol patterns and distress from heart palpitations in midlife women. METHODS We analyzed baseline data from 293 women who were eligible for a 3 × 2 factorial trial of exercise or yoga versus routine activity, and omega-3 fish oil versus placebo for vasomotor symptoms. Women self-collected salivary cortisol using swabs at four time points over 2 consecutive days and reported distress from heart racing or pounding during the past 2 weeks using a single item. Sample description and covariate data included demographics, clinical data, vasomotor symptom frequency from daily diaries, medication use, and validated questionnaires on depression, stress, and insomnia (Patient Health Questionnaire-8, Perceived Stress Scale, and Insomnia Severity index). Data were analyzed using descriptive statistics, chi-square and t tests, and repeated measure linear regression models. RESULTS Participants were on average 54.6 (SD = 3.6) years old, most were White (67%) postmenopausal (84%), and 26% reported distress related to palpitations. In adjusted models, the morning (wake plus 30-min) geometric mean daily salivary cortisol concentrations were significantly more blunted in those with distress from palpitations compared with those without distress (P ≤ 0.03). When all covariates were controlled, distress from palpitations was the sole significant predictor of wake plus 30-minute cortisol (-0.25 [-0.45 to -0.04], P = 0.02). CONCLUSIONS Palpitations among midlife women may be associated with blunted morning cortisol, and this relationship is not explained by demographics, clinical variables, vasomotor symptoms, medications, depression, stress, or insomnia.
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Affiliation(s)
| | - James E. Tisdale
- Purdue University College of Pharmacy, West Lafayette, IN 47907
- Indiana University School of Medicine, Indianapolis, IN 46202
| | - Joseph C. Larson
- Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Ying Sheng
- Indiana University School of Nursing, Indianapolis, IN 46202
| | - Chen X. Chen
- Indiana University School of Nursing, Indianapolis, IN 46202
| | - Diane Von Ah
- Indiana University School of Nursing, Indianapolis, IN 46202
| | - Richard Kovacs
- Indiana University School of Medicine, Indianapolis, IN 46202
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Hou H, Adzika GK, Wu Q, Ma T, Ma Y, Geng J, Shi M, Fu L, Rizvi R, Gong Z, Sun H. Estrogen Attenuates Chronic Stress-Induced Cardiomyopathy by Adaptively Regulating Macrophage Polarizations via β 2-Adrenergic Receptor Modulation. Front Cell Dev Biol 2021; 9:737003. [PMID: 34650984 PMCID: PMC8506112 DOI: 10.3389/fcell.2021.737003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/31/2021] [Indexed: 12/31/2022] Open
Abstract
Clinical demographics have demonstrated that postmenopausal women are predisposed to chronic stress-induced cardiomyopathy (CSC) and this has been associated with the decrease of estrogen. Meanwhile, recent studies have implicated unsolved myocardial proinflammatory responses, which are characterized by enormous CD86+ macrophage infiltrations as an underlying disease mechanism expediting the pathological remodeling of the heart during chronic stress. However, we had previously demonstrated that estrogen confers cardioprotection via the modulation of cardiomyocytes β2-adrenoceptors (β2AR)-Gs/Gi pathways during stress to lessen the incidence of stress-induced cardiovascular diseases in premenopausal women. Intriguingly, macrophages express β2AR profoundly as well; as such, we sought to elucidate the possibilities of estrogen modulating β2AR-Gs/Gi pathway to confer cardioprotection during stress via immunomodulation. To do this, ovariectomy (OVX) and sham operations (Sham) were performed on female Sprague-Dawley (SD) rats. Two weeks after OVX, the rats were injected with 40 μg/kg/day of estradiol (E2). Next, on day 36 after OVX, chronic stress was induced by a daily subcutaneous injection of 5 mg/kg/day of isoproterenol (ISO). The effect of E2 on relevant clinical cardiac function indexes (LVSP, LVEDP, + dp/dt and −dp/dt), myocardial architecture (cardiomyocyte diameter and fibrosis), β2AR alterations, and macrophage (CD86+ and CD206+) infiltrations were assessed. In vitro, peritoneal macrophages (PMΦ) were isolated from wild-type and β2AR-knockout female mice. The PMΦ were treated with ISO, E2, and β2AR blocker ICI 118,551 for 24 h, and flow cytometric evaluations were done to assess their phenotypic expression. E2 deficiency permitted the induction of CSC, which was characterized by cardiac dysfunctions, maladaptive myocardial hypertrophy, unresolved proinflammatory responses, and fibrosis. Nonetheless, E2 presence/supplementation during stress averted all the aforementioned adverse effects of chronic stress while preventing excessive depletion of β2AR. Also, we demonstrated that E2 facilitates timely resolution of myocardial proinflammation to permit reparative functions by enhancing the polarization of CD86+ to CD206+ macrophages. However, this adaptive immunomodulation is hampered when β2AR is inhibited. Taken together, the outcomes of this study show that E2 confers cardioprotection to prevent CSC via adaptive immunomodulation of macrophage phenotypes, and β2AR-mediated signaling is crucial for the polarizations of CD86+ to CD206+ macrophages.
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Affiliation(s)
- Hongjian Hou
- Department of Physiology, Xuzhou Medical University, Xuzhou, China.,The College of Biology and Food, Shangqiu Normal University, Shangqiu, China
| | | | - Qi Wu
- Department of Physiology, Xuzhou Medical University, Xuzhou, China
| | - Tongtong Ma
- Department of Physiology, Xuzhou Medical University, Xuzhou, China
| | - Yanhong Ma
- Department of Physiology, Xuzhou Medical University, Xuzhou, China
| | - Juan Geng
- Department of Physiology, Xuzhou Medical University, Xuzhou, China
| | - Mingjin Shi
- Department of Physiology, Xuzhou Medical University, Xuzhou, China
| | - Lu Fu
- Department of Physiology, Xuzhou Medical University, Xuzhou, China
| | | | - Zheng Gong
- The School of Public Affairs and Governance, Silliman University, Dumaguete, Philippines
| | - Hong Sun
- Department of Physiology, Xuzhou Medical University, Xuzhou, China.,Xuzhou Medical University, Xuzhou, China
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Sheng Y, Carpenter JS, Elomba CD, Alwine JS, Yue M, Chen CX, Tisdale JE. Effect of menopausal symptom treatment options on palpitations: a systematic review. Climacteric 2021; 25:128-140. [PMID: 34346265 DOI: 10.1080/13697137.2021.1948006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This systematic review provides an overview of the effects of menopausal symptom treatment options on palpitations, defined as feelings of missed or exaggerated heart beats, reported by perimenopausal and postmenopausal women. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searches were conducted in PubMed, CINAHL and PsycINFO to identify articles meeting pre-specified inclusion criteria. Of 670 unique articles identified, 37 were included in the review. Treatments included drug therapies and non-drug therapies. Palpitations were studied as an outcome in 89% of articles and as an adverse effect in 11%. Articles provided mostly level II/III evidence due to their design and/or small sample sizes. Based on available evidence, no therapies can be fully recommended for clinical practice. Only some hormonal agents (e.g. estradiol) can be recommended with caution based on some positive evidence for reducing palpitation prevalence or severity. However, other drug therapies (e.g. moxonidine, atenolol), dietary supplementary treatments (e.g. isoflavones, Rheum rhaponticum, sage), cognitive-behavioral intervention and auricular acupressure cannot be recommended given the existing evidence. Additional well-designed randomized controlled treatment trials focusing on palpitations during the menopause transition as an inclusion criteria and outcome are needed to advance the field.
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Affiliation(s)
- Y Sheng
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - J S Carpenter
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - C D Elomba
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - J S Alwine
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - M Yue
- College of Pharmacy, Purdue University, West Lafayette, IN, USA
| | - C X Chen
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - J E Tisdale
- College of Pharmacy, Purdue University, West Lafayette, IN, USA.,School of Medicine, Indiana University, Indianapolis, IN, USA
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9
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Reame NK. Anxiety and hot flashes as predictors of mid-life palpitations: getting to the heart of the matter in the time of COVID-19. Menopause 2021; 28:731-734. [PMID: 34165445 PMCID: PMC8240496 DOI: 10.1097/gme.0000000000001808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 11/26/2022]
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10
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Sheng Y, Carpenter JS, Elomba CD, Alwine JS, Yue M, Pike CA, Chen CX, Tisdale JE. Review of menopausal palpitations measures. Womens Midlife Health 2021; 7:5. [PMID: 34059122 PMCID: PMC8167994 DOI: 10.1186/s40695-021-00063-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/11/2021] [Indexed: 12/22/2022] Open
Abstract
Palpitations are reported commonly by women around the time of menopause as skipped, missed, irregular, and/or exaggerated heartbeats or heart pounding. However, much less is known about palpitations than other menopausal symptoms such as vasomotor symptoms. The objective of this review was to integrate evidence on menopausal palpitations measures. Keyword searching was done in PubMed, CINAHL, and PsycINFO for English-language, descriptive articles containing data on menopause and palpitations and meeting other pre-specified inclusion criteria. Of 670 articles, 110 met inclusion criteria and were included in the review. Results showed that 11 different measures were used across articles, with variability within and between measures. Inconsistencies in the wording of measurement items, recall periods, and response options were observed even when standardized measures were used. Most measures were limited to assessing symptom presence and severity. Findings suggest that efforts should be undertaken to (1) standardize conceptual and operational definitions of menopausal palpitations and (2) develop a patient-friendly, conceptually clear, psychometrically sound measure of menopausal palpitations.
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Affiliation(s)
- Ying Sheng
- School of Nursing, Indiana University, Indianapolis, IN, 46202, USA
| | - Janet S Carpenter
- School of Nursing, Indiana University, Indianapolis, IN, 46202, USA.
| | - Charles D Elomba
- School of Nursing, Indiana University, Indianapolis, IN, 46202, USA
| | | | - Min Yue
- College of Pharmacy, Purdue University, West Lafayette, IN, 47907, USA
| | - Caitlin A Pike
- University Library, Indiana University, Indianapolis, IN, 46202, USA
| | - Chen X Chen
- School of Nursing, Indiana University, Indianapolis, IN, 46202, USA
| | - James E Tisdale
- College of Pharmacy, Purdue University, West Lafayette, IN, 47907, USA.,School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
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