Effect of mental stress on left ventricular ejection fraction and its relationship to the severity of coronary artery disease
| Autor: | Takeshi Shikama, Toru Kuroda, Yuji Mikami, Kiyotaka Fujii, Toshihiro Saito, Rei Hasegawa, Kouki Matsuno, Jiro Nakaya, Yoichi Kuwabara, Yoshiaki Masuda, Satoshi Watanabe |
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| Rok vydání: | 2000 |
| Předmět: |
Male
medicine.medical_specialty Hemodynamics Blood Pressure Coronary Disease Radionuclide ventriculography Ventricular Function Left Coronary artery disease Catecholamines Internal medicine Heart rate medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Radionuclide Ventriculography Aged Aged 80 and over Tomography Emission-Computed Single-Photon Neurotransmitter Agents Ejection fraction business.industry Stroke Volume General Medicine Middle Aged Radiocardiography medicine.disease Blood pressure Exercise Test Cardiology Female Radiopharmaceuticals business Perfusion Stress Psychological |
| Zdroj: | European Journal of Nuclear Medicine. 27:1760-1767 |
| ISSN: | 1619-7089 0340-6997 |
| DOI: | 10.1007/s002590000383 |
| Popis: | To evaluate the relationship between the mental stress-induced decrease in left ventricular ejection fraction (LVEF) and the severity of exercise-induced ischaemia, 20 patients with stable coronary artery disease (CAD) underwent radionuclide ventriculography during mental stress testing and stress myocardial perfusion single-photon emission tomography (SPET). We also examined whether changes in haemodynamic and neurohormonal parameters are related to changes in LVEF during mental stress. The LVEF decreased from 54.8% +/- 17.7% to 49.8% +/- 16.2% with mental stress (P0.0005). Ten of the 20 patients (50.0%) had aor = 5% decrease in LVEF The remaining ten patients had no or a5% decrease in LVEF There was a significant correlation between the change in LVEF during mental stress and the size of the reversible defect on stress myocardial perfusion SPET (r = -0.80, P0.0005), with close regional correspondence (75% identical). This correlation was less strong in the 12 patients with a total defect score at rest of10 (r = -0.69, P = 0.014) than in the eight patients with a total defect score at rest ofor = 10 (r = -0.94, P = 0.001). The changes in blood pressure and heart rate were not significantly correlated with the change in LVEF, but the percent change in adrenaline concentration correlated with the change in LVEE It is suggested that mental stress impairs systolic function by inducing transient myocardial ischaemia. The effect of neurohormonal responses during mental stress on LV systolic function may also be important in patients with CAD. |
| Databáze: | OpenAIRE |
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