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Atrial Septal Aneurysm and Anxiety: A Matched Cross-Sectional Study with Prospective Enrollment Exploring Clinical and Psychosomatic Associations

Year: 2026

Type: article

Abstract: Background/Objectives: An isolated atrial septal aneurysm (ASA) represents a distinct structural anomaly defined by abnormal bulging of the interatrial tissue, affecting roughly three percent of the general public. Although routinely viewed as an accidental discovery during imaging, this condition carries recognized associations with adverse clinical events, notably cerebrovascular ischemia and rhythm disturbances. Because the interplay between cardiovascular diseases and psychological distress is well established, our primary goal was to determine if individuals harboring this septal anomaly display elevated symptoms of anxiety or depression relative to standard cardiology outpatients. Methods: For this comparative cross-sectional investigation, we recruited a total of one hundred and twenty adults from a dedicated cardiology clinic. The cohort consisted of sixty individuals diagnosed with the septal anomaly and sixty healthy control subjects, carefully paired according to age and gender. Every participant received a comprehensive clinical baseline assessment, which included a 12-lead electrocardiogram alongside a detailed two-dimensional transthoracic echocardiogram. Psychological status was assessed using the State–Trait Anxiety Inventory (STAI-1 for state anxiety and STAI-2 for trait anxiety) and the Beck Depression Inventory (BDI). Results: Initial physical and demographic profiling—specifically regarding patient age, gender distribution, and calculated body mass indices—revealed no significant statistical variances between the two study arms. The ASA group presented with a significantly higher prevalence of clinical palpitations (83.3% vs. 43.3%, p < 0.001). Furthermore, the ASA group exhibited significantly higher scores on all psychometric measures (STAI-1: 44.97 ± 9.15 vs. 32.53 ± 8.24, p < 0.001; STAI-2: 49.37 ± 7.22 vs. 34.72 ± 10.55, p < 0.001; BDI: 19.66 ± 9.79 vs. 10.07 ± 6.81, p < 0.001). After confirming the absence of severe multicollinearity (Variance Inflation Factor < 5), exploratory logistic regression analysis demonstrated that clinical palpitations (odds ratio [OR]: 5.309; 95% confidence interval [CI]: 1.621–17.383; p = 0.006) and trait anxiety scores (STAI-2) (OR: 1.169 per one-point increment; 95% CI: 1.062–1.286; p = 0.001) were independently associated factors for the presence of ASA. Conclusions: This study demonstrates a significant clinical association between ASA, clinical palpitations, and persistent trait anxiety (STAI-2). While the cross-sectional design precludes causal inferences, the findings suggest a clinical clustering of anxiety and palpitations in patients diagnosed with ASA. This highlights the importance of recognizing potential psychosomatic overlaps in structural heart diseases.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm15208046

Authors: Doğaç Çağlar Gürbüz, Hasan Atmaca, Hicran Damar, Mustafa Kemal Erol, Ertan Yetkin