| Mental stress hemodynamic responses and myocardial ischemia: does left ventricular dysfunction alter these relationships? | |
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MedLine Citation:
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PMID: 17636152 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess if mental stress hemodynamic responses are impaired and related to mental stress (MS) ischemia in patients with left ventricular (LV) dysfunction. BACKGROUND: Impaired LV function is an important coronary artery disease (CAD) risk factor and hemodynamic characteristics play an important role in clinical outcomes. Patients with severe LV dysfunction (SLVD) are frequently excluded from prior studies and the effects of LV dysfunction on MS hemodynamic responses are not known. METHODS: Fifty-eight patients with CAD, consisting of 22 patients with normal LV function (ejection fraction (EF) > or =50%), 16 patients with mild-to-moderate LV dysfunction (30% < EF < 50%), and 20 patients with severe LV dysfunction (EF < or =30) underwent bicycle exercise (EX) and MS testing with 12-lead electrocardiogram and monitoring of vital signs on consecutive days in random order. Blood pressure and heart rate (HR) measurements were obtained. Ischemia was measured using single photon emission computed tomography. RESULTS: Both MS and EX produced significant increases in all hemodynamic measurements. HR levels were higher both at rest and during MS in SLVD patients. LV groups increased similarly from rest to stress (both MS and EX) for all measurements except HR during MS, which increased more in patients with SLVD than patients with normal LV function. Hemodynamic responses to MS were not related to myocardial ischemia or heart failure symptoms. CONCLUSIONS: HR response during MS is increased in patients with SLVD, whereas blood pressure responses are similar to those in patients with preserved LV function. Hemodynamic reactivity is unrelated to MS-induced ischemia. |
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Authors:
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Sari D Holmes; David S Krantz; Willem J Kop; Albert Del Negro; Pamela Karasik; John S Gottdiener |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2007-07-16 |
Journal Detail:
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Title: Psychosomatic medicine Volume: 69 ISSN: 1534-7796 ISO Abbreviation: Psychosom Med Publication Date: 2007 Jul-Aug |
Date Detail:
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Created Date: 2007-07-20 Completed Date: 2007-08-31 Revised Date: 2007-12-03 |
Medline Journal Info:
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Nlm Unique ID: 0376505 Medline TA: Psychosom Med Country: United States |
Other Details:
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Languages: eng Pagination: 495-500 Citation Subset: IM |
Affiliation:
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Uniformed Services University of the Health Sciences, Department of Medical and Clinical Psychology, Bethesda, MD 20814, USA. sholmes@usuhs.mil |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Anger Blood Pressure* Exercise Female Heart Rate* Humans Male Middle Aged Myocardial Ischemia / physiopathology, psychology* Stress, Psychological / complications, physiopathology* Ventricular Dysfunction, Left / complications* |
| Grant Support | |
ID/Acronym/Agency:
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HL47337/HL/NHLBI NIH HHS; T32HL069751/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
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Psychosom Med. 2007 Jul-Aug;69(6):491-2
[PMID:
17641143
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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