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

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. The present research addresses the role of psychophysiologic responsiveness reactivity, lipid levels, and atherosclerotic severity as moderators of coronary artery constriction dilation 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 HDL, 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.