Exploring the impact of mental stress and coronary artery stenosis on brain functional status of CAHD patients and the related mechanism
Chi Yunpeng
Zhang Lijun
Liu Meiyan
Shen Xiaoran
Bao Yanping
Huang Xiaorong
Chen Haiyang
Abstract：Objective To explore the impact of mental stress and coronary artery stenosis on brain functional status in patients with coronary atherosclerotic heart disease(CAHD),and to investigate the immune mechanisms related to lymphocyte subsets in different brain functional statuses.Methods CAHD patients admitted to the Department of Cardiology,Beijing Anzhen Hospital,from August to December 2023,who met the inclusion and exclusion criteria,were included.Baseline data were collected,including scores for depression,anxiety,perceived stress,sleep status,and cognitive function.Lymphocyte subsets were detected by flow cytometry.Brain functional status was assessed by a dynamic electroencephalogram system.The Gensini scoring system was used to quantify the severity of coronary artery lesions.The relationships among coronary lesion severity,mental health-related scale scores,and brain functional status(brain workload,brain fatigue,emotional stress)were analyzed using partial least square-structural equation modeling(PLS-SEM)with SmartPLS 4.0 software.Results A total of 213 CAHD patients were included,with a median age of 62(56,68)years,including 149 men(69.95%).The scores of depression,anxiety,perceived stress,sleep,and cognitive function were 1(0,4),1(0,3),42(39,46),3(1,8),and 29(27,30),respectively.Brain function scores were as follows:brain load 50(36.5,66),strain and excitement 18(9,27),emotional stress 39(30,54),fatigue index 16(9,23.5),brain activity 56(45,62),brain tiredness 34(18,70).PLS-SEM analysis showed positive correlations between sleep score and anxiety score(t=3.649,P＜0.001),sleep and depression(t=2.337,P=0.019),sleep and perceived stress(t=2.593,P=0.010),anxiety and depression(t=13.216,P＜0.001).There was a positive correlation between perceived stress score and coronary lesion severity(t=2.889,P=0.004),and a negative correlation between coronary lesion severity and brain functional status(t=2.296,P=0.022).Compared with patients with normal brain workload,those with severe brain workload had significantly lower CD3+%and significantly higher CD3-CD19+%,and CD3-CD19+absolute count..Compared with patients with normal brain fatigue,those with severe brain fatigue had significantly lower CD3+%and CD3+CD8+%,and significantly higher CD3-CD19+%absolute count.Compared with patients with moderate emotional stress,those with severe emotional stress had significantly higher absolute counts of CD3-CD19+,CD3+CD4+,CD3-CD19+(P＜0.05).Conclusion CAHD patients with higher mental stress may have more severe coronary artery lesions;in addition,there is a negative correlation between the severity of coronary artery lesions and brain functional status,and the potential mechanism is associated with immune regulation.
Keywords：Coronary artery severityPerceive stressBrain functional statusLymphocyte subsets
Publication Date：2025-08-20
Online Publishing Date：2025-10-24(First online date of this platform, not the publication date of the document)
Pages：6( 933-938 )