Document Detail


Repolarization changes induced by mental stress in normal subjects and patients with coronary artery disease: effect of nitroglycerine.
MedLine Citation:
PMID:  19124615     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Mental stress can significantly affect ventricular repolarization, which could potentially trigger arrhythmias. We compared the effect of mental stress on repolarization indexed by the amplitude and area of the T wave in patients with coronary artery disease (CAD) and healthy subjects. METHODS: Fourteen healthy controls (11 M, mean age 42 years) and 14 patients with stable CAD (12 M, mean age 64) underwent a mental stress protocol consisting of mental arithmetic followed by a speech (5 minutes each), which was performed on two occasions following either nitroglycerine (NTG) or placebo. Multiple 12-lead electrocardiograms were acquired and repolarization was analyzed using automatically measured T wave amplitude (T(amp)) and area (T(area)). RESULTS: When preceded by placebo the overall effect of mental stress, whether induced by arithmetic or speech, was significantly different in CAD patients compared with controls, with a decrease in T(amp) and T(area) in controls and an increase in patients; e.g., change in T(amp) during arithmetic -20 +/- 3 microV in controls versus 4 +/- 2 microV in patients, p < .001, and during speech -9 +/- 3 microV in controls versus 7 +/- 1 microV in patients, p < .001. Following NTG, the effect of stress on repolarization was similar in the 2 groups, with a reversed effect, i.e., decrease instead of increase in T(amp) and T(area) in CAD patients. CONCLUSIONS: The effect of mental stress on ventricular repolarization is significantly different in CAD patients compared with healthy controls. These differences are considerably reduced by NTG.
Authors:
Peter Taggart; Velislav N Batchvarov; Peter Sutton; Geoff Young; Sharon Young; David Patterson
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-01-05
Journal Detail:
Title:  Psychosomatic medicine     Volume:  71     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-15     Completed Date:  2009-05-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  23-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, The Hatter Institute and Centre for Cardiology, University College London Hospitals, London, UK. peter.taggart@uclh.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Artery Disease / complications,  physiopathology*
Electrocardiography / drug effects*
Female
Heart Rate / drug effects
Heart Ventricles / drug effects*,  physiopathology
Humans
Male
Mathematics
Membrane Potentials / drug effects,  physiology
Middle Aged
Nitroglycerin / pharmacology*
Pilot Projects
Sampling Studies
Speech
Stress, Psychological / complications,  physiopathology*
Vasodilator Agents / pharmacology*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 55-63-0/Nitroglycerin

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


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