Mental stress-induced myocardial ischemia in women with angina and normal coronary angiograms.
J Nucl Cardiol
; 13(4): 507-13, 2006 Jul.
Article
em En
| MEDLINE
| ID: mdl-16919574
ABSTRACT
BACKGROUND:
Coronary artery disease is frequent in postmenopausal women. Silent myocardial ischemia has been induced with mental stress testing. METHODS ANDRESULTS:
To evaluate whether mental stress can induce ischemia in women with typical angina and normal coronary angiography, postmenopausal patients (n = 16) were studied. Each underwent technetium 99m methoxyisobutylisonitrile myocardial scintigraphy (exercise stress/rest/mental stress protocol), brachial artery endothelial function measurement by ultrasonography, and 24-hour ambulatory electrocardiographic recording (Holter). During mental stress testing, 6 patients (group I) had reversible perfusion defects on myocardial scintigraphy whereas the other 10 patients (group II) did not. Group I patients exhibited endothelial dysfunction more frequently than those in group II (83% vs 20%). Myocardial scintigraphy showed anteroapical/septal ischemia in 5 patients and inferoapical ischemia in one other patient, with both types of stress. Among group II patients, none showed a reversible perfusion defect during physical or mental stress. No group I patients had evidence of ischemia by Holter monitoring, whereas 2 of 10 group II patients did.CONCLUSION:
In postmenopausal women with typical angina and normal coronary arteries, mental stress may provoke myocardial ischemia, which can be concordant with ischemia induced by exercise stress, and is associated with endothelial dysfunction.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estresse Psicológico
/
Doença da Artéria Coronariana
/
Angina Pectoris
/
Infarto do Miocárdio
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2006
Tipo de documento:
Article