Accession Number:

ADA440950

Title:

Moderators of Coronary Vasomotion during Mental Stress in Coronary Artery Disease Patients: Stress Reactivity, Serum Lipoproteins, and Severity of Atherosclerosis

Descriptive Note:

Doctoral thesis

Corporate Author:

UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD DEPT OF MEDICAL AND CLINICAL PSYCHOLOGY

Personal Author(s):

Report Date:

1996-08-30

Pagination or Media Count:

136.0

Abstract:

Impaired coronary artery vasomotion in response to behavioral triggers such as mental stress may be an important pathophysiological process involved in acute manifestations of coronary artery disease. This research addresses the role of psychophysiologic responsiveness reactivity, lipid levels, and atherosclerotic severity as moderators of coronary artery constrictiondilation in response to mental stress. Forty-five patients 39 males mean age 59 years undergoing diagnostic coronary angiography completed the study. Quantitative coronary angiography QCA was used to assess the diameter changes induced by mental stress and nitroglycerine administration. Changes in blood pressure, heart rate, and self-reported mood to mental stress, levels of serum LDL and NDL, and percent fixed stenosis at baseline by QCA were examined as moderators of vasomotion. Results indicated that mental stress significantly increased blood pressure, heart rate, and self-reported distress. Contrary to predictions, atherosclerotic segments did not constrict more than angiographically smooth segments. Instead, results revealed specific moderators of the coronary diameter response to mental stress in both atherosclerotic and smooth segments. In atherosclerotic coronary segments n33, stress reactivity but not coronary risk factors, lipoproteins, or severity of atherosclerosis moderated the coronary response to mental stress. Specifically, higher blood pressure reactivity was related to greater coronary vasoconstriction. In smooth coronary segments n45, hypertension independently moderated the coronary response to mental stress and stress reactivity blood pressure and heart rate responses interacted with LDL levels in predicting coronary vasomotion. Preliminary evidence in males that higher LDL levels were related to constriction to mental stress suggest that coronary risk factors may play a greater role in smooth coronary segments as opposed to atherosclerotic segments.

Subject Categories:

  • Psychology
  • Anatomy and Physiology
  • Medicine and Medical Research

Distribution Statement:

APPROVED FOR PUBLIC RELEASE