Mental stress is associated with coronary endothelial dysfunction in women with chest pain and non-obstructive coronary artery disease

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-09-22 DOI:10.1016/j.ijcha.2025.101802

Jaskanwal Deep S Sara , Nazanin Rajai , Scott Breitinger , Betsy Medina-Inojosa , Lilach O Lerman , Amir Lerman

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引用次数: 0

Abstract

Objective

We evaluate the association between chronic mental stress (MS) and coronary endothelial function in patients with chest pain and nonobstructive coronary artery disease (CAD) separately in males and females.

Methods

Patients with nonobstructive CAD (stenosis <40 %) at coronary angiography underwent an invasive assessment for coronary endothelial dysfunction (CED). Macrovascular CED was defined as a percentage change in coronary artery diameter to acetylcholine (%ΔCADAch) ≤ −10 % and microvascular CED was defined as a percentage change in coronary blood flow to acetylcholine (%ΔCBFAch) ≤−50 %. Patients completed a questionnaire within 2 years of the index procedure that included questions regarding chronic MS. The frequency of macrovascular, microvascular and any type of CED was compared across groups. Logistic regression analyses were performed to assess the association between MS and CED.

Results

Between January 2017 and December 2022, 211 patients (mean (sd) age 54.4 (13.6) yrs, 71.0 % female) were included. One hundred forty-two (67.3 %) patients had any type of CED. In females with significant MS there was a higher proportion of individuals with any type of CED compared to without CED (43 (42.6 %) vs. 12 (24.5 %), p = 0.0362). In a multivariable analysis MS was associated with any type of CED in females: OR (95 % CI) 2.70 (1.24–6.25); p = 0.0156.

Conclusion

Chronic MS is associated with CED in females with chest pain and nonobstructive CAD. Chronic MS may underly the mechanism for chest pain in these patients and may play a contributory to cardiovascular disease through its association with endothelial dysfunction.

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精神压力与胸痛和非阻塞性冠状动脉疾病女性冠状动脉内皮功能障碍相关

目的探讨胸痛和非阻塞性冠状动脉疾病（CAD）患者慢性精神应激（MS）与冠状动脉内皮功能的关系。方法非阻塞性CAD（狭窄<； 40%）患者在冠状动脉造影时接受冠状动脉内皮功能障碍（CED）的侵入性评估。大血管CED定义为冠状动脉直径对乙酰胆碱的百分比变化（%ΔCADAch）≤- 10%，微血管CED定义为冠状动脉血流量对乙酰胆碱的百分比变化（%ΔCBFAch）≤- 50%。患者在指标手术后2年内完成一份问卷，其中包括关于慢性ms的问题，比较各组大血管、微血管和任何类型CED的频率。采用Logistic回归分析来评估多发性硬化症与CED之间的关系。结果2017年1月至2022年12月，纳入211例患者（平均（sd）年龄54.4（13.6）岁，女性71.0%）。142例（67.3%）患者有任何类型的CED。在有明显多发性硬化症的女性中，有任何类型的CED的个体比例高于没有CED的个体（43人（42.6%）比12人（24.5%），p = 0.0362）。在多变量分析中，MS与女性任何类型的CED相关：OR (95% CI) 2.70 (1.24-6.25)；p = 0.0156。结论女性胸痛合并非阻塞性CAD患者慢性MS与CED相关。慢性多发性硬化症可能是这些患者胸痛的潜在机制，并可能通过与内皮功能障碍相关而导致心血管疾病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.