Mental stress-induced myocardial ischemia in patients with stable coronary heart disease: a relevant clinic study
He Dongfang
Zhang Lijun
Yang Ya
Pu Lihong
Xu Liyuan
Liu Meiyan
Abstract：Objective To study the relationship among severity of coronary artery stenosis, severity of coronary artery calcification (CAC), depression-anxiety and mental stress-induced myocardial ischemia (MSIMI), and relationship between blood pressure response and CAC under mental stress in patients with stable coronary heart disease (CHD). Methods CHD patients (n=48, male 33, female 15 and average age=58.04±10.41) were chosen from Department of Cardiology of Beijing Anzhen Hospital from June 1, 2017 to Nov. 8, 2017. The depression status was reviewed by using self-rating scale of 9-item patient health questionnaire (PHQ-9), and anxiety status was reviewed by using questionnaire of 7-item generalized anxiety disorder (GAD-7). The severity of coronary artery stenosis and grades of CAC were reviewed respectively by using Gensini scoring and CAC grading criterion. The patients were given ultrasonic inspection of mental stress. The venous blood samples were collected for detecting indexes of heart function before and after mental stress inspection, and meanwhile blood pressure (BP) was detected. Results The incidence of MSIMI was 18.8% in CHD patients, which was 22.2% in those with 1-vessel lesion, 6.7% in those with 2-vessel lesion and 25.0% in those with 3-vessel lesion. The incidence of MSIMI was 19.2% in patients with grade 0 CAC, 28.6% in those with grade 1 CAC, 14.3% in those with grade 2 CAC, and 12.5% in those with grade 3 CAC. The comparison between MSIMI group and non-MSIMI group showed that the difference in sex, age, and cardiac biomarkers (hs-cTnI, CK-MB, MYO), PHQ-9 scores, GAD-7 scores, scores of coronary artery stenosis and stents numbers before and after mental stress inspection had no statistical significance (all P>0.05). CAC, depression, anxiety and tension occurred during the inspection had no increasing effect on MSIMI risk. The level of systolic blood pressure (SBP) was higher in CAC group than that in non-CAC group before, during and after the inspection (all P<0.05). After correcting sex, age, BMI, hypertension, diabetes and hyperlipidmia, SBP before, during and after the inspection was the risk factor of CAC. Conclusion The severity of coronary artery lesion and CAC may not be the key factor of MSIMI, while mental state is closely related to MSIMI. SBP under mental stress is the risk factor of CAC.
Keywords：Coronary heart diseaseCoronary artery stenosisCoronary artery calcificationMental stress-induced myocardial ischemia
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 319-323 )