Document Detail

The impact of anxiety disorders on assessment of myocardial ischemia and exercise stress test performance.
MedLine Citation:
PMID:  20724935     Owner:  NLM     Status:  In-Process    
PURPOSE: To evaluate the sensitivity of electrocardiogram (ECG) versus single photon emission computed tomography (SPECT) assessments of ischemia in patients with anxiety disorders (AD) and the extent to which patients exhibit poorer exercise performance, compared with patients without AD.
METHODS: Patients referred for nuclear exercise stress testing (N = 2271) underwent a structured psychiatric interview (PRIME-MD) to assess for AD. Exercise performance parameters were assessed during ECG treadmill testing, after which patients underwent SPECT imaging.
RESULTS: Analyses revealed that patients with AD exhibited lower peak exercise systolic blood pressure and rate pressure product than patients without AD. When major depressive disorder was included as an additional covariate, the previous results became trends. Results also indicated a lower rate of electrically positive ecg tests and a higher rate of false-negative diagnoses of myocardial ischemia according to ecg among patients with AD. Including major depressive disorder as a covariate rendered the effects of ad nonsignificant. There was no evidence of reduced exercise performance in patients with AD.
CONCLUSIONS: Findings suggest that AD may be associated with mild impairments in cardiovascular exercise reactivity and may also alter the detection of myocardial ischemia using ecg assessments in patients referred for exercise stress testing. However, the influence of AD appears to be moderated by comorbid depression. Results suggest that exercise test performance and detection of ischemia may be influenced by mood and/or anxiety disorders and that greater efforts should be made to include routine mood and/or anxiety disorder screening as part of exercise stress testing protocols.
Roxanne Pelletier; Simon L Bacon; Catherine Laurin; André Arsenault; Richard P Fleet; Kim L Lavoie
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiopulmonary rehabilitation and prevention     Volume:  31     ISSN:  1932-751X     ISO Abbreviation:  J Cardiopulm Rehabil Prev     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-01-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101291247     Medline TA:  J Cardiopulm Rehabil Prev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  60-6     Citation Subset:  IM    
Montreal Behavioural Medicine Centre, Research Centre, Montreal Heart Institute, 5000 Belanger, Montreal, Quebec, Canada.
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Grant Support
79445//Canadian Institutes of Health Research; 89965//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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