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This study aims to evaluate the real\u2010time effects of experimentally induced PTSD symptom activation on various cardiac contractility and autonomic measures. We recorded synchronized electrocardiogram and impedance cardiogram from 137 male veterans (17 PTSD, 120 non\u2010PTSD; 48 twin pairs, 41 unpaired singles) during a laboratory\u2010based traumatic reminder stressor. To identify the parameters describing the cardiac mechanisms by which trauma reminders can create stress on the heart, we utilized a feature selection mechanism along with a random forest classifier distinguishing PTSD and non\u2010PTSD. We extracted 99 parameters, including 76 biosignal\u2010based and 23 sociodemographic, medical history, and psychiatric diagnosis features. A subject\/twin\u2010wise stratified nested cross\u2010validation procedure was used for parameter tuning and model assessment to identify the important parameters. The identified parameters included biomarkers such as pre\u2010ejection period, acceleration index, velocity index, Heather index, and several physiology\u2010agnostic features. These identified parameters during trauma recall suggested a combination of increased sympathetic nervous system (SNS) activity and deteriorated cardiac contractility that may increase the heart failure risk for PTSD. This indicates that the PTSD symptom activation associates with real\u2010time reductions in several cardiac contractility measures despite SNS activation. This finding may be useful in future cardiac prevention efforts.<\/jats:p>","DOI":"10.1111\/psyp.14488","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T23:04:33Z","timestamp":1700607873000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impedance cardiogram based exploration of cardiac mechanisms in post\u2010traumatic stress disorder during trauma recall"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-7187","authenticated-orcid":false,"given":"Shafa\u2010at Ali","family":"Sheikh","sequence":"first","affiliation":[{"name":"Department of Biomedical Informatics Emory University  Atlanta Georgia USA"},{"name":"School of Electrical and Computer Engineering Georgia Institute of Technology  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9099-9687","authenticated-orcid":false,"given":"Amit J.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health, Emory University  Atlanta Georgia USA"},{"name":"Veterans Affairs Health Care System  Washington District of Columbia USA"},{"name":"Department of Medicine, Division of Cardiology Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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