January 1, 1998Japanese Circulation JournalOpen Access

Effect of Mental Stress on Hemodynamics and Left Ventricular Diastolic Function in Patients With Ischemic Heart Disease

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Ischemic heart disease (n=15). Intervention: Mental calculation stress (MS) test vs. Baseline / Patients without significant coronary stenosis. Primary outcome: Hemodynamics and left ventricular diastolic function.

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Key result

A mental calculation stress test induced left ventricular diastolic dysfunction, decreasing early diastolic mitral flow velocity by 10.0% in patients with significant coronary artery stenosis.

Why the study?

Does mental calculation stress affect hemodynamics and left ventricular diastolic function in patients with ischemic heart disease?

Population

15 patients with ischemic heart disease, including 7 with old myocardial infarction with significant…

Comparison

Mental calculation stress test. vs Baseline resting state and treadmill exercise…

Design

Cross-sectional

Authors

YOYoko OkanoNagasaki Municipal Hospital TUToshinori UtsunomiyaTakao Hospital KYKatsusuke YanoNagasaki University

Discussion

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Implication

Mental stress may impair LV diastolic function in CAD; hypothesis-generating for diagnostic utility.

Key Points

Evaluate the effects of mental calculation stress on hemodynamics and left ventricular diastolic function in patients with ischemic heart disease.
Assessed 15 patients categorized into Group I (n=7, old myocardial infarction with significant coronary artery stenosis) and Group II (n=8, chest pain with non-significant stenosis).
Administered a 10-minute mental stress test involving backward digit recall for 5 minutes and serial subtraction of 17 from 1000 for 5 minutes.
Measured blood pressure, heart rate, and Doppler mitral flow velocity parameters periodically during stress testing.
Mental stress increased mean blood pressure by 38.3%, heart rate by 17.3%, and rate pressure product by 62.1% across all subjects.
Early diastolic mitral flow velocity decreased by 10.0% in Group I versus 3.3% in Group II, while the first third filling rate decreased by 32.3% in Group I versus 22.8% in Group II.
The mitral flow velocity A/E ratio increased by 39.3% in Group I compared to 25.8% in Group II, reflecting more severe left ventricular diastolic impairment in patients with significant coronary stenosis.

Study Design

Type

Observational (n=15)

Structured PICO

Does mental calculation stress affect hemodynamics and left ventricular diastolic function in patients with ischemic heart disease?

Population

15 patients with ischemic heart disease (7 with old MI and significant stenosis, 8 with chest pain syndrome and non-significant stenosis) undergoing a mental calculation stress test.

Exposure

Mental calculation stress (MS) test (memorizing 6 random numeral digits, repeating in reverse order for 5 min, followed by serial subtraction of 1000 minus 17 for 5 min).

Comparator

Baseline resting state and treadmill exercise test.

Outcome

Hemodynamics (blood pressure, heart rate, rate pressure product) and left ventricular diastolic function (Doppler mitral flow velocity [MFV], early diastolic MFV, first third filling rate of MFV, A/E ratio).surrogate

Mental stress induces left ventricular diastolic dysfunction, with a more pronounced effect in patients with significant coronary artery stenosis compared to those without.

Cite This Study

Okano et al. (1998) conducted an observational in Ischemic heart disease (n=15). Mental calculation stress (MS) test vs. Baseline / Patients without significant coronary stenosis was evaluated on Hemodynamics and left ventricular diastolic function. A mental calculation stress test induced left ventricular diastolic dysfunction, decreasing early diastolic mitral flow velocity by 10.0% in patients with significant coronary artery stenosis.

synapsesocial.com/papers/6a1ffa92c1b320180d0dbb2f https://doi.org/10.1253/jcj.62.173

Topics

Women and heart disease

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Effect of Mental Stress on Hemodynamics and Left Ventricular Diastolic Function in Patients With Ischemic Heart Disease

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Effect of Mental Stress on Hemodynamics and Left Ventricular Diastolic Function in Patients With Ischemic Heart Disease

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

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