Document Detail

Mental stress-induced myocardial ischemia in women with angina and normal coronary angiograms.
MedLine Citation:
PMID:  16919574     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Coronary artery disease is frequent in postmenopausal women. Silent myocardial ischemia has been induced with mental stress testing. METHODS AND RESULTS: To evaluate whether mental stress can induce ischemia in women with typical angina and normal coronary angiography, postmenopausal patients (n = 16) were studied. Each underwent technetium 99m methoxyisobutylisonitrile myocardial scintigraphy (exercise stress/rest/mental stress protocol), brachial artery endothelial function measurement by ultrasonography, and 24-hour ambulatory electrocardiographic recording (Holter). During mental stress testing, 6 patients (group I) had reversible perfusion defects on myocardial scintigraphy whereas the other 10 patients (group II) did not. Group I patients exhibited endothelial dysfunction more frequently than those in group II (83% vs 20%). Myocardial scintigraphy showed anteroapical/septal ischemia in 5 patients and inferoapical ischemia in one other patient, with both types of stress. Among group II patients, none showed a reversible perfusion defect during physical or mental stress. No group I patients had evidence of ischemia by Holter monitoring, whereas 2 of 10 group II patients did. CONCLUSION: In postmenopausal women with typical angina and normal coronary arteries, mental stress may provoke myocardial ischemia, which can be concordant with ischemia induced by exercise stress, and is associated with endothelial dysfunction.
Amalia Peix; Angelina Trápaga; Lucrecia Asen; Felizardo Ponce; Olga Infante; Juan Valiente; Francisco Tornés; Lázaro O Cabrera; Israel Guerrero; Ernesto J García; Regla Carrillo; David García-Barreto
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  13     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-08-21     Completed Date:  2006-09-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  507-13     Citation Subset:  IM    
Nuclear Medicine Department, Institute of Cardiology, La Habana, Cuba.
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MeSH Terms
Angina Pectoris / etiology,  radiography,  radionuclide imaging*
Coronary Angiography
Coronary Artery Disease / complications*,  radiography,  radionuclide imaging*
False Negative Reactions
False Positive Reactions
Middle Aged
Myocardial Infarction / etiology*,  radiography,  radionuclide imaging*
Risk Assessment / methods
Risk Factors
Stress, Psychological / complications*
Women's Health
Comment In:
J Nucl Cardiol. 2006 Jul;13(4):450-6   [PMID:  16919568 ]

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