Key result
In patients with coronary artery disease after acute coronary syndrome, higher total fatigue was significantly associated with diminished heart rate (β = -0.324) and systolic blood pressure (β = -0.331) reactivity during anticipatory mental stress.
Why the study?
Studies exploring the relationship between fatigue and cardiovascular reactivity to stress in coronary artery disease patients were scarce and inconsistent.
Is fatigue associated with diminished cardiovascular response to anticipatory stress in patients with CAD after ACS?
Cross-Sectional (n=142)
No
Is fatigue associated with diminished cardiovascular response to anticipatory stress in patients with CAD after ACS?
Effect estimate: β = -0.324
p-value: p=0.01
In CAD patients recovering from ACS, higher levels of fatigue are associated with a blunted cardiovascular response to anticipatory mental stress.
Fatigue-linked blunted reactivity should not yet change practice in post-ACS CAD; hypothesis-generating for prospective autonomic studies.
Background Fatigue and psychophysiological reactions to mental stress are known to be problematic in coronary artery disease (CAD) patients. Currently, studies exploring the relationship between fatigue and cardiovascular reactivity to stress are scarce and inconsistent. The current study aimed to investigate the links between cardiovascular response to mental stress and fatigue in CAD patients after acute coronary syndrome (ACS). Methods The cross-sectional study investigated 142 CAD patients (85% males, 52 ± 8 years) within 2–3 weeks after recent myocardial infarction or unstable angina pectoris. Fatigue symptoms were measured using Multidimensional Fatigue Inventory 20-items, while cardiovascular reactivity to stress [i.e., systolic (S) and diastolic (D) blood pressure (ΔBP), and heart rate (ΔHR)] was evaluated during Trier Social Stress Test (TSST). In addition, participants completed psychometric measures, including the Hospital Anxiety and Depression scale and the Type D Scale-14. Multivariable linear regression analyses were completed to evaluate associations between fatigue and cardiovascular response to TSST, while controlling for confounders. Results After controlling for baseline levels of cardiovascular measures, age, gender, education, heart failure severity, arterial hypertension, smoking history, use of nitrates, anxiety and depressive symptoms, Type D Personality, perceived task difficulty, and perceived task efforts, cardiovascular reactivity to anticipatory stress was inversely associated with both global fatigue (ΔHR: β = –0.238; p = 0.04) and mental fatigue (ΔSBP: β = –0.244; p = 0.04; ΔHR β = –0.303; p = 0.01) as well as total fatigue (ΔSBP: β = –0.331; p = 0.01; ΔHR: β = –0.324; p = 0.01). Conclusion In CAD patients after ACS, fatigue was linked with diminished cardiovascular function during anticipation of a mental stress challenge, even after inclusion of possible confounders. Further similar studies exploring other psychophysiological stress responses are warranted.
No takes yet. Share an insight, caveat, or question.
Gečaitė-Stončienė et al. (2021) conducted a cross-sectional in Coronary Artery Disease (CAD) after Acute Coronary Syndrome (ACS) (n=142). Fatigue vs. Lower fatigue levels was evaluated on Cardiovascular reactivity to anticipatory stress (change in heart rate during TSST task instruction) (β = -0.324, p=0.01). In patients with coronary artery disease after acute coronary syndrome, higher total fatigue was significantly associated with diminished heart rate (β = -0.324) and systolic blood pressure (β = -0.331) reactivity during anticipatory mental stress.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: