Document Detail


Sympathetically mediated effects of mental stress on the cardiac microcirculation of patients with coronary artery disease.
MedLine Citation:
PMID:  7611145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mental stress often causes myocardial ischemia in patients with coronary artery disease (CAD). There is increasing evidence that the coronary microcirculation of patients with atherosclerosis may be dysfunctional, with the potential of contributing to myocardial ischemia. This study investigated sympathetically mediated coronary microcirculatory and regional noradrenergic effects of mental stress. We measured left anterior descending coronary artery blood flow and norepinephrine kinetics at rest and during a 10-minute video game in 10 CAD patients with nonsignificant atherosclerosis of this artery and in 5 patients with normal coronary angiograms (NCA). The 2 groups did not differ in their responses of systemic and cardiac norepinephrine spillovers, heart rate, and blood pressure during mental stress. Patients with NCA had microvascular dilation during mental stress (26 +/- 9% [mean +/- SD] decline in coronary vascular resistance from baseline, p < 0.01), whereas patients with CAD did not (9 +/- 20% decline, p = 0.11). Six patients with CAD then received intracoronary phentolamine (1.7 micrograms/kg/min for 5 minutes, followed by 0.17 micrograms/kg/min) and played the video game again. In contrast to nonsignificant changes in coronary resistance during the initial video game (6 +/- 15% decline, p = 0.20), coronary vascular resistance decreased significantly during the repeat video game (25 +/- 19% decline, p = 0.02). Vasomotor responses of epicardial coronary artery segments did not differ between the 2 video game studies. Five other patients (4 with CAD, 1 with NCA) repeated the video game during intracoronary administration of 5% dextrose, with systemic and coronary hemodynamic and noradrenergic responses unchanged from those during the initial video game.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
N Dakak; A A Quyyumi; G Eisenhofer; D S Goldstein; R O Cannon
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  76     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1995 Jul 
Date Detail:
Created Date:  1995-08-17     Completed Date:  1995-08-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  125-30     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892-1650.
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MeSH Terms
Descriptor/Qualifier:
Aged
Chest Pain / blood,  diagnosis,  physiopathology
Coronary Angiography
Coronary Circulation / drug effects,  physiology*
Coronary Disease / blood,  diagnosis,  physiopathology*
Female
Heart Catheterization / instrumentation,  methods
Hemodynamics / drug effects
Humans
Male
Microcirculation / drug effects,  physiopathology
Middle Aged
Norepinephrine / blood,  diagnostic use
Phentolamine / administration & dosage,  diagnostic use
Stress, Psychological / blood,  diagnosis,  physiopathology*
Sympathetic Nervous System / drug effects,  physiopathology*
Tritium
Chemical
Reg. No./Substance:
10028-17-8/Tritium; 50-60-2/Phentolamine; 51-41-2/Norepinephrine

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


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