TY - JOUR
T1 - Inflammatory response to mental stress and mental stress induced myocardial ischemia
AU - Hammadah, Muhammad
AU - Sullivan, Samaah
AU - Pearce, Brad
AU - Al Mheid, Ibhar
AU - Wilmot, Kobina
AU - Ramadan, Ronnie
AU - Tahhan, Ayman Samman
AU - O'Neal, Wesley T.
AU - Obideen, Malik
AU - Alkhoder, Ayman
AU - Abdelhadi, Naser
AU - Mohamed Kelli, Heval
AU - Ghafeer, Mohamad Mazen
AU - Pimple, Pratik
AU - Sandesara, Pratik
AU - Shah, Amit J.
AU - Hosny, Kareem Mohammed
AU - Ward, Laura
AU - Ko, Yi An
AU - Sun, Yan V.
AU - Weng, Lei
AU - Kutner, Michael
AU - Bremner, J. Douglas
AU - Sheps, David S.
AU - Esteves, Fabio
AU - Raggi, Paolo
AU - Vaccarino, Viola
AU - Quyyumi, Arshed A.
N1 - Publisher Copyright:
© 2017
PY - 2018/2
Y1 - 2018/2
N2 - Background: Mental stress-induced myocardial ischemia (MSIMI) is associated with increased risk of adverse cardiovascular outcomes, yet the underlying mechanisms are not well understood. We measured the inflammatory response to acute laboratory mental stress in patients with coronary artery disease (CAD) and its association with MSIMI. We hypothesized that patients with MSIMI would have a higher inflammatory response to mental stress in comparison to those without ischemia. Methods: Patients with stable CAD underwent 99mTc sestamibi myocardial perfusion imaging during mental stress testing using a public speaking stressor. MSIMI was determined as impaired myocardial perfusion using a 17-segment model. Inflammatory markers including interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), matrix metallopeptidase 9 (MMP-9) and high-sensitivity C reactive protein (hsCRP) were measured at rest and 90 min after mental stress. Results were validated in an independent sample of 228 post-myocardial infarction patients. Results: Of 607 patients analyzed in this study, (mean age 63 ± 9 years, 76% male), 99 (16.3%) developed MSIMI. Mental stress resulted in a significant increase in IL-6, MCP-1, and MMP-9 (all p <0.0001), but not hsCRP. However, the changes in these markers were similar in those with and without MSIMI. Neither resting levels of these biomarkers, nor their changes with mental stress were significantly associated with MSIMI. Results in the replication sample were similar. Conclusion: Mental stress is associated with acute increases in several inflammatory markers. However, neither the baseline inflammatory status nor the magnitude of the inflammatory response to mental stress over 90 min were significantly associated with MSIMI.
AB - Background: Mental stress-induced myocardial ischemia (MSIMI) is associated with increased risk of adverse cardiovascular outcomes, yet the underlying mechanisms are not well understood. We measured the inflammatory response to acute laboratory mental stress in patients with coronary artery disease (CAD) and its association with MSIMI. We hypothesized that patients with MSIMI would have a higher inflammatory response to mental stress in comparison to those without ischemia. Methods: Patients with stable CAD underwent 99mTc sestamibi myocardial perfusion imaging during mental stress testing using a public speaking stressor. MSIMI was determined as impaired myocardial perfusion using a 17-segment model. Inflammatory markers including interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), matrix metallopeptidase 9 (MMP-9) and high-sensitivity C reactive protein (hsCRP) were measured at rest and 90 min after mental stress. Results were validated in an independent sample of 228 post-myocardial infarction patients. Results: Of 607 patients analyzed in this study, (mean age 63 ± 9 years, 76% male), 99 (16.3%) developed MSIMI. Mental stress resulted in a significant increase in IL-6, MCP-1, and MMP-9 (all p <0.0001), but not hsCRP. However, the changes in these markers were similar in those with and without MSIMI. Neither resting levels of these biomarkers, nor their changes with mental stress were significantly associated with MSIMI. Results in the replication sample were similar. Conclusion: Mental stress is associated with acute increases in several inflammatory markers. However, neither the baseline inflammatory status nor the magnitude of the inflammatory response to mental stress over 90 min were significantly associated with MSIMI.
KW - C reactive protein
KW - Inflammation
KW - Interleukin 6
KW - Matrix metallopeptidase 9
KW - Mental stress
KW - Monocyte chemoattractant protein-1
KW - Myocardial ischemia
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U2 - 10.1016/j.bbi.2017.10.004
DO - 10.1016/j.bbi.2017.10.004
M3 - Article
C2 - 28986223
AN - SCOPUS:85031668697
SN - 0889-1591
VL - 68
SP - 90
EP - 97
JO - Brain, Behavior, and Immunity
JF - Brain, Behavior, and Immunity
ER -