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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

Correlations between stress intensity and global left ventricular (LV) strain (A) and endothelial parameters (B and C). The value of global LV strain and FMD/NTG-induced dilatation showed significant correlation with global severity index. FMD: flow-mediated dilatation, NTG: nitroglycerine, GSI: global severity index.
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Figure 2: Correlations between stress intensity and global left ventricular (LV) strain (A) and endothelial parameters (B and C). The value of global LV strain and FMD/NTG-induced dilatation showed significant correlation with global severity index. FMD: flow-mediated dilatation, NTG: nitroglycerine, GSI: global severity index.

Mentions: Global severity index showed significant correlations with GLS (r=0.384, p=0.002). The value of GLS correlated robustly with the nine items of the SCL-90-R, with the significant correlations being with paranoid ideation (r=0.472, p<0.001), phobic anxiety (r=0.405, p<0.001), anxiety (r=0.402, p=0.001), compulsivity (r=0.376, p=0.002), depression (r=0.330, p=0.008), and interpersonal sensitivity (r=0.329, p=0.008). Somatization, hostility, and psychoticism showed poor correlation with GLS (Table 3). GSI also showed significant correlations with reactive FMD (r=-0.583, p<0.001) and NTG-induced FMD (r=-0.342, p=0.006) (Fig. 2). Multivariate linear regression analysis showed that GSI was the only significant attributor to GLS (β=0.149, p=0.008) and reactive FMD (β=-0.200, p=0.041). However, age was the only significant attributor to NTG-induced FMD (Table 4).


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)

Correlations between stress intensity and global left ventricular (LV) strain (A) and endothelial parameters (B and C). The value of global LV strain and FMD/NTG-induced dilatation showed significant correlation with global severity index. FMD: flow-mediated dilatation, NTG: nitroglycerine, GSI: global severity index.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Correlations between stress intensity and global left ventricular (LV) strain (A) and endothelial parameters (B and C). The value of global LV strain and FMD/NTG-induced dilatation showed significant correlation with global severity index. FMD: flow-mediated dilatation, NTG: nitroglycerine, GSI: global severity index.
Mentions: Global severity index showed significant correlations with GLS (r=0.384, p=0.002). The value of GLS correlated robustly with the nine items of the SCL-90-R, with the significant correlations being with paranoid ideation (r=0.472, p<0.001), phobic anxiety (r=0.405, p<0.001), anxiety (r=0.402, p=0.001), compulsivity (r=0.376, p=0.002), depression (r=0.330, p=0.008), and interpersonal sensitivity (r=0.329, p=0.008). Somatization, hostility, and psychoticism showed poor correlation with GLS (Table 3). GSI also showed significant correlations with reactive FMD (r=-0.583, p<0.001) and NTG-induced FMD (r=-0.342, p=0.006) (Fig. 2). Multivariate linear regression analysis showed that GSI was the only significant attributor to GLS (β=0.149, p=0.008) and reactive FMD (β=-0.200, p=0.041). However, age was the only significant attributor to NTG-induced FMD (Table 4).

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