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Impact of chronic emotional stress on myocardial function in postmenopausal women and its relationship with endothelial dysfunction.

Kim HS, Cho KI - Korean Circ J (2013)

Bottom Line: The study participants were divided into two groups, based on global severity index (GSI): ≥50 (group A, n=27) or <50 (group B, n=37).Although there were no significant differences in LV geometry or myocardial performance indices between the groups, global LV strain was significantly reduced in group A compared to group B (-16.6±2.7% vs. -19.1±1.9%, p=0.001).Multivariate linear regression analysis showed that GSI was the only significant attributor to global LV strain (β=0.149, p=0.008) and reactive FMD (β=-0.200, p=0.041).

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, Kosin University School of Medicine, Busan, Korea.

ABSTRACT

Background and objectives: An association between chronic stress and cardiovascular diseases has been described, but the underlying mechanisms have not been fully elucidated. We investigate the impact of perceived stress on the left ventricular (LV) and endothelial functions in postmenopausal women.

Subjects and methods: We investigated 64 consecutive postmenopausal women (mean age 56.7±9.7 years) with atypical chest pain and chronic stress. Patients with coronary heart disease were excluded. Global and segmental longitudinal deformation parameters of LV were used as parameters to assess myocardial function and brachial flow-mediated dilatation (FMD) was used to assess the endothelial function, and patients were analyzed by the Symptom Checklist 90 Revised (SCL-90-R) to determine emotional stress. The study participants were divided into two groups, based on global severity index (GSI): ≥50 (group A, n=27) or <50 (group B, n=37).

Results: Although there were no significant differences in LV geometry or myocardial performance indices between the groups, global LV strain was significantly reduced in group A compared to group B (-16.6±2.7% vs. -19.1±1.9%, p=0.001). There were also significant differences in the value of reactive FMD (6.6±2.2% vs. 9.5±2.9%, p<0.001), and same result was observed for nitroglycerine-induced dilatation (14.6±4.7% vs. 18.0±5.8%, p=0.016). Multivariate linear regression analysis showed that GSI was the only significant attributor to global LV strain (β=0.149, p=0.008) and reactive FMD (β=-0.200, p=0.041).

Conclusion: Chronic emotional stress may exert negative effects on the LV and endothelial functions, which may be associated with the severity of stress. This study provides a possible mechanism by which stress is associated with an increased risk of cardiovascular dysfunction.

No MeSH data available.


Related in: MedlinePlus

Bull's eye pattern analyses in patients with stress using two-dimensional speckle tracking strain analysis. A: a subject without stress, showed normal segmental and global left ventricular strain. However, subjects with high stress, such as B (global severity index, GSI=74) and C (GSI=68), D (GSI=72), showed abnormal segmental and global left ventricular strain. GSI: global severity index.
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Figure 1: Bull's eye pattern analyses in patients with stress using two-dimensional speckle tracking strain analysis. A: a subject without stress, showed normal segmental and global left ventricular strain. However, subjects with high stress, such as B (global severity index, GSI=74) and C (GSI=68), D (GSI=72), showed abnormal segmental and global left ventricular strain. GSI: global severity index.

Mentions: Global LV systolic function, LV chamber dimension, and LV mass index were normal in all patients with stress. There were no significant differences in the mitral inflow parameters or diastolic function between groups A and B. However, the values of the peak systolic LV strains of group A were significantly lower in three apical views, including the apical long axis view, the apical 4-chamber view, and the apical 2-chamber view, compared to group B (Fig. 1, Table 2). The GLS of group A was also significantly different compared with that of group B (-16.6±2.7% vs. -19.1±1.9%, p<0.001). Inter-observer and intra-observer variability was corrected for by independent analysis by two independent observers (C.K.I and H.S.K.) and by repeated measurement of these segments on another occasion by the same observer. The intra-observer regression coefficient was 0.92 and the inter-observer regression coefficient was 0.88. The main cause of inter-observer variability was the different locations of the sample volume. Once the sample volume was placed at a mutually agreed-upon location within the myocardium, measurements became virtually identical.


Impact of chronic emotional stress on myocardial function in postmenopausal women and its relationship with endothelial dysfunction.

Kim HS, Cho KI - Korean Circ J (2013)

Bull's eye pattern analyses in patients with stress using two-dimensional speckle tracking strain analysis. A: a subject without stress, showed normal segmental and global left ventricular strain. However, subjects with high stress, such as B (global severity index, GSI=74) and C (GSI=68), D (GSI=72), showed abnormal segmental and global left ventricular strain. GSI: global severity index.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3675303&req=5

Figure 1: Bull's eye pattern analyses in patients with stress using two-dimensional speckle tracking strain analysis. A: a subject without stress, showed normal segmental and global left ventricular strain. However, subjects with high stress, such as B (global severity index, GSI=74) and C (GSI=68), D (GSI=72), showed abnormal segmental and global left ventricular strain. GSI: global severity index.
Mentions: Global LV systolic function, LV chamber dimension, and LV mass index were normal in all patients with stress. There were no significant differences in the mitral inflow parameters or diastolic function between groups A and B. However, the values of the peak systolic LV strains of group A were significantly lower in three apical views, including the apical long axis view, the apical 4-chamber view, and the apical 2-chamber view, compared to group B (Fig. 1, Table 2). The GLS of group A was also significantly different compared with that of group B (-16.6±2.7% vs. -19.1±1.9%, p<0.001). Inter-observer and intra-observer variability was corrected for by independent analysis by two independent observers (C.K.I and H.S.K.) and by repeated measurement of these segments on another occasion by the same observer. The intra-observer regression coefficient was 0.92 and the inter-observer regression coefficient was 0.88. The main cause of inter-observer variability was the different locations of the sample volume. Once the sample volume was placed at a mutually agreed-upon location within the myocardium, measurements became virtually identical.

Bottom Line: The study participants were divided into two groups, based on global severity index (GSI): ≥50 (group A, n=27) or <50 (group B, n=37).Although there were no significant differences in LV geometry or myocardial performance indices between the groups, global LV strain was significantly reduced in group A compared to group B (-16.6±2.7% vs. -19.1±1.9%, p=0.001).Multivariate linear regression analysis showed that GSI was the only significant attributor to global LV strain (β=0.149, p=0.008) and reactive FMD (β=-0.200, p=0.041).

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, Kosin University School of Medicine, Busan, Korea.

ABSTRACT

Background and objectives: An association between chronic stress and cardiovascular diseases has been described, but the underlying mechanisms have not been fully elucidated. We investigate the impact of perceived stress on the left ventricular (LV) and endothelial functions in postmenopausal women.

Subjects and methods: We investigated 64 consecutive postmenopausal women (mean age 56.7±9.7 years) with atypical chest pain and chronic stress. Patients with coronary heart disease were excluded. Global and segmental longitudinal deformation parameters of LV were used as parameters to assess myocardial function and brachial flow-mediated dilatation (FMD) was used to assess the endothelial function, and patients were analyzed by the Symptom Checklist 90 Revised (SCL-90-R) to determine emotional stress. The study participants were divided into two groups, based on global severity index (GSI): ≥50 (group A, n=27) or <50 (group B, n=37).

Results: Although there were no significant differences in LV geometry or myocardial performance indices between the groups, global LV strain was significantly reduced in group A compared to group B (-16.6±2.7% vs. -19.1±1.9%, p=0.001). There were also significant differences in the value of reactive FMD (6.6±2.2% vs. 9.5±2.9%, p<0.001), and same result was observed for nitroglycerine-induced dilatation (14.6±4.7% vs. 18.0±5.8%, p=0.016). Multivariate linear regression analysis showed that GSI was the only significant attributor to global LV strain (β=0.149, p=0.008) and reactive FMD (β=-0.200, p=0.041).

Conclusion: Chronic emotional stress may exert negative effects on the LV and endothelial functions, which may be associated with the severity of stress. This study provides a possible mechanism by which stress is associated with an increased risk of cardiovascular dysfunction.

No MeSH data available.


Related in: MedlinePlus