Jaskanwal Deep S Sara , Nazanin Rajai , Scott Breitinger , Betsy Medina-Inojosa , Lilach O Lerman , Amir Lerman
{"title":"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","authors":"Jaskanwal Deep S Sara , Nazanin Rajai , Scott Breitinger , Betsy Medina-Inojosa , Lilach O Lerman , Amir Lerman","doi":"10.1016/j.ijcha.2025.101802","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101802"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mental stress is associated with coronary endothelial dysfunction in women with chest pain and non-obstructive coronary artery disease\",\"authors\":\"Jaskanwal Deep S Sara , Nazanin Rajai , Scott Breitinger , Betsy Medina-Inojosa , Lilach O Lerman , Amir Lerman\",\"doi\":\"10.1016/j.ijcha.2025.101802\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>\",\"PeriodicalId\":38026,\"journal\":{\"name\":\"IJC Heart and Vasculature\",\"volume\":\"61 \",\"pages\":\"Article 101802\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-09-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IJC Heart and Vasculature\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352906725002052\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IJC Heart and Vasculature","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352906725002052","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Mental stress is associated with coronary endothelial dysfunction in women with chest pain and non-obstructive coronary artery disease
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.
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.