The Relation of Psychosocial Distress With Myocardial Perfusion and Stress-Induced Myocardial Ischemia.
Objective: Mental stress-induced myocardial ischemia is a frequent phenomenon in patients with coronary artery disease (CAD). The link between an integrated measure of chronic psychosocial distress and mental stress-induced myocardial ischemia, and whether it differs by sex, has not been examined be...
| Publicado en: | Psychosomatic Medicine Vol. 81; no. 4; pp. 363 - 372 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
May2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136368267&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136368267 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00333174 2C8 jtl: Psychosomatic Medicine issn: 00333174 maglogo: N pubinfo: dt: May2019 vid: 81 iid: 4 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 136368267 136368267 NLM30676537 10.1097/PSY.0000000000000674 NLM30676537 136368267 ppf: 363 ppct: 9 formats: tig: atl: The Relation of Psychosocial Distress With Myocardial Perfusion and Stress-Induced Myocardial Ischemia. aug: au: Pimple, Pratik Hammadah, Muhammad Wilmot, Kobina Ramadan, Ronnie Al Mheid, Ibhar Levantsevych, Oleksiy Sullivan, Samaah Lima, Bruno B. Kim, Jeong Hwan Garcia, Ernest V. Nye, Jonathon Shah, Amit J. Ward, Laura Raggi, Paolo Bremner, J. Douglas Hanfelt, John Lewis, Tené T. Quyyumi, Arshed A. Vaccarino, Viola affil: From the Department of Epidemiology (Pimple, Sullivan, Shah, Lewis, Vaccarino), Rollins School of Public Health, Emory University sug: subj: Myocardial Ischemia Etiology Coronary Circulation Stress, Psychological Complications Sex Factors Aged Psychological Tests Myocardial Ischemia Male Middle Age Female Stress, Psychological Physiopathology Myocardial Ischemia Psychosocial Factors Heart Function Tests Scales Aged: 65+ years Middle Aged: 45-64 years Male Female ab: Objective: Mental stress-induced myocardial ischemia is a frequent phenomenon in patients with coronary artery disease (CAD). The link between an integrated measure of chronic psychosocial distress and mental stress-induced myocardial ischemia, and whether it differs by sex, has not been examined before.Methods: We used latent class analysis to derive a composite measure of psychosocial distress integrating scales of depression, posttraumatic stress, anxiety, anger, hostility, and perceived stress in 665 individuals with stable CAD. Participants underwent myocardial perfusion imaging with mental stress and perfusion defects were quantified at rest (summed rest score), with mental stress (summed stress score), and their difference (summed difference score), the latter being an index of inducible ischemia.Results: The M (SD) age was 63 (9) years, and 185 (28%) were women. Latent class analysis characterized the study sample into four distinct classes of incremental psychosocial distress. In women, class 4 (highest distress) had an adjusted 4.0-point higher summed rest score (95% confidence interval = 0.2-7.7) as compared with class 1 (lowest distress), whereas no difference was observed in men (-0.87 points, 95% confidence interval = -3.74 to 1.99, p = .04 for interaction). There was no association between the psychosocial distress latent variable and summed difference score in either women or men.Conclusions: Among patients with CAD, a higher level of psychosocial distress is not associated with mental stress ischemia, but it is associated with more resting (fixed) perfusion abnormalities in women only, as well as with blunted hemodynamic response to mental stress in both men and women. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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