# Association Between Psychosocial Stress and Premature Ventricular Contractions During the Recovery Phase Following Treadmill Testing in Asymptomatic Individuals

## TL;DR

Psychosocial stress is linked to a higher risk of heart rhythm irregularities after exercise in otherwise healthy people.

## Contribution

This study identifies psychosocial stress as a novel risk factor for PVCs during post-exercise recovery in asymptomatic individuals.

## Key findings

- Psychosocial stress was associated with a 9.03-fold higher risk of PVCs during recovery.
- Higher BMI was linked to a 9% lower risk of PVCs during recovery.
- Stress and BMI were the only factors significantly associated with PVCs in this population.

## Abstract

Introduction: Ventricular arrhythmias may lead to sudden cardiac death and, when occurring during the recovery phase after exercise testing, are associated with increased cardiovascular risk. Aim: To investigate the association between psychosocial stress and the risk of premature ventricular contractions (PVCs) during the recovery phase after treadmill testing in asymptomatic individuals. Methods: A total of 282 asymptomatic adults underwent treadmill testing. Participants were categorized into a stress-present group (+S, n = 176) or a stress-absent group (−S, n = 106) based on their self-reported psychosocial stress levels. Inclusion criteria included exercising for at least 6 min and reaching at least 85% of the age-predicted maximum heart rate. Exclusion criteria comprised pre-exercise VAs, unreadable ECGs, chronic medication use, systolic blood pressure ≥180 mmHg, and diastolic blood pressure ≥110 mmHg. This study was registered on ClinicalTrials.gov (NCT05987891). Results: Compared to the −S group, the +S group had a higher body mass index (BMI) (p = 0.0025); 26.5 (23.9; 29.0) and larger waist circumference (p = 0.0001); 95 (86; 103), and reported lower physical activity levels (p = 0.0004). Notably, only psychosocial stress and BMI were statistically associated with PVCs during the recovery phase, immediately following the stress test. For each 1 kg/m2 increase in BMI, the risk of PVCs decreased by 9%. Participants reporting psychosocial stress had a 9.03-fold higher risk of PVCs compared to those who did not report stress. Conclusions: Self-reported psychosocial stress significantly increases the risk of PVC occurrence during the recovery phase of treadmill exercise testing in asymptomatic individuals. These findings may support the development of improved PVC detection strategies and enhance cardiovascular risk assessment in clinical settings.