Vascular Responses During Mental Stress

精神压力期间的血管反应

• 批准号: 7931290
• 负责人: ARSHED A QUYYUMI
• 金额: $ 21.18万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7931290
• 关键词: Accounting; Acetylcholine; Acute; Adenosine; Blood Vessels; Blood flow; C-reactive protein; Cessation of life; Coronary; Coronary Arteriosclerosis; Defect; Deterioration; Development; Diagnosis; Disodium Salt Nitroprusside; Endothelium; Evaluation; Event; Exercise; Exposure to; Functional disorder; Goals; Heart failure; Image; Inflammation; Inflammatory; Inflammatory Response; Ischemia; Laboratories; Lead; Left; Life; Measurement; Measures; Mediating; Microcirculation; Modeling; Myocardial Infarction; Myocardial Ischemia; Outcome; Patients; Perfusion; Peripheral; Physiologic pulse; Plasma; Psyche structure; Reaction; Rest; Risk; Severity of illness; Stress; Stress Tests; Structure; Testing; Therapeutic; Ultrasonography; Ventricular; abstracting; arterial stiffness; arterial tonometry; base; brachial artery; constriction; experience; follow-up; indexing; prognostic; psychologic; response; secondary outcome; single photon emission computed tomography; stressor; sudden cardiac death

Abstract Previous studies show that mental stress-induced ischemia is characteristically silent, may account for up to 75% of the total ischemic burden experienced during normal daily life, and is associated with worse long term outcome. However, the coronary and peripheral vascular changes that accompany mental stress in patients with coronary artery disease (CAD) with and without ischemia during mental stress have not been investigated, and are likely to be crucial in providing understanding of the underiying mechanisms that lead to increased risk in these patients. The overall goal of the project is to investigate whether abnormal vascular reactivity of (a) the coronary and/or (b) peripheral vasculature and (c) a pro-inflammatory response contribute to myocardial ischemia during mental stress in subjects with CAD. This will: 1) provide a mechanistic understanding of the underiying coronary and peripheral vascular alterations and systemic inflammatory changes that accompany mental stress in patients with CAD, and how they contribute to myocardial ischemia; 2) identify peripheral vascular and/or inflammatory predictors of mental stress-induced ischemia (MSI) during SPECT; and 3) determine whether subjects who have a more abnormal reaction to mental stress testing, by repeated exposure to daily life psychologic stressors, develop greater vascular dysfunction and more severe systemic inflammation during follow-up. The results of our studies will assist development of 1) specific therapeutic approaches for treatment of MSI that is associated with adverse long term outcome, and 2) new model of mental stress-based stress testing for prognostic evaluation conventionally evaluated by exercise or pharmacologic tests.

抽象的 先前的研究表明，精神压力引起的缺血通常是无声的，可能是导致 正常日常生活中经历的总缺血负担的 75%，并且与长期恶化有关 结果。然而，患者精神压力伴随的冠状动脉和周围血管变化 尚未对精神压力期间伴有或不伴有缺血的冠状动脉疾病 (CAD) 进行研究， 并且可能对于了解导致风险增加的潜在机制至关重要 在这些患者中。该项目的总体目标是调查 (a) 冠状动脉和/或 (b) 外周脉管系统和 (c) 促炎反应的异常血管反应性是否会导致 CAD 受试者精神应激期间的心肌缺血。这将： 1) 提供对 CAD 患者伴随精神应激的潜在冠状动脉和外周血管改变以及全身炎症变化的机制理解，以及它们如何导致心肌缺血； 2) 在 SPECT 过程中确定精神应激引起的缺血 (MSI) 的外周血管和/或炎症预测因子； 3）确定对精神压力测试反应更异常的受试者，通过反复暴露于日常生活心理压力源，在随访过程中是否会出现更严重的血管功能障碍和更严重的全身炎症。我们的研究结果将有助于开发 1）治疗与不良长期结果相关的 MSI 的特定治疗方法，以及 2）新的治疗模型 基于精神压力的压力测试用于预后评估 通常通过运动或药理测试来评估。