Sex-Specific Patterns of Myocardial Ischemia During Mental and Conventional Stress

精神和常规应激期间心肌缺血的性别特异性模式

• 批准号: 9911804
• 负责人: Zakaria Almuwaqqat
• 金额: $ 6.49万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9911804
• 关键词: Adverse effects; Affect; Algorithms; American; Biological Markers; Blood Pressure; Blood Vessels; Blood flow; Cardiovascular Diseases; Cardiovascular system; Coronary; Coronary Angiography; Coronary Arteriosclerosis; Coronary artery; Coronary heart disease; Databases; Development; Diagnosis; Diffuse; Diffuse Pattern; Disease; Event; Exercise; Functional disorder; Future; Goals; Heart Rate; Heart failure; High Prevalence; Impairment; Incidence; Individual; Intervention; Ischemia; Laboratories; Lesion; Life; Methods; Microvascular Dysfunction; Morbidity - disease rate; Myocardial; Myocardial Infarction; Myocardial Ischemia; Myocardial perfusion; Obstruction; Outcome; Pathogenesis; Patients; Pattern; Peripheral; Pharmacology; Play; Populations at Risk; Predisposition; Premature Mortality; Psyche structure; Psychological Stress; Psychosocial Stress; Public Health; Recurrence; Research; Rest; Risk; Risk Factors; Role; Secondary to; Sex Differences; Standardization; Stress; Time; United States; Unstable angina; Vasomotor; Woman; Work; adjudication; adverse outcome; cardiovascular risk factor; clinically significant; cohort; coronary event; coronary vasoconstriction; disability; endothelial dysfunction; experience; follow-up; high risk; imaging study; improved; indexing; male; men; mortality; novel; patient population; psychosocial; response; sex; stressor; young woman

Abstract Cardiovascular disease (CVD) continues to be a leading cause of disability and premature mortality in the United States and globally, Recently, young women have been found to be disproportionately affected by CVD with rising incident of myocardial infarctions raising concerns for potentially novel disease mechanisms and risk factors. Psychosocial stress is believed to play a role in the pathogenesis of coronary artery disease and myocardial infarction among this vulnerable patient population. At the same time, recent studies have shown that stress might be implicated in the differential pattern of CVD among men and women as they may have different incidence and mechanisms of cardiovascular proclivity to stress. However, key sex-related differences in biomarkers and mechanisms remain elusive. Therefore, the identification of differences in the pattern of myocardial ischemia during mental and physical stress will allow for the better characterization of at-risk populations and may facilitate understanding mechanisms of myocardial ischemia during mental stress and its relation to non-obstructive coronary artery disease. In this application, we will develop and use a novel algorithm applied to rest/stress myocardial perfusion imaging studies in conjunction with coronary angiography results from the Myocardial Infarction and Mental Stress 2 (MIMS-2) database to quantify regional homogeneity of myocardial ischemia. Aim 1 will compare the pattern of myocardial ischemia (focal vs diffuse) in men and women and during mental and physical stress. In Aim 2, we will investigate the association of diffuse mild myocardial ischemia as quantified by the novel algorithm with adverse cardiovascular outcomes. The proposed analyses will provide plausible evidence to understand the effects of diffuse myocardial ischemia on coronary artery function and myocardial blood flow at the levels of blood vessel segments and its association with adverse cardiovascular outcomes. Additionally, this research will provide a context to use in our interpretations of subjects improve our understanding of susceptibility to myocardial ischemia and the relationship between myocardial ischemia, mental stress and coronary artery disease.

抽象的 心血管疾病（CVD）仍然是导致残疾和过早死亡的主要原因 在美国和全球范围内，最近发现年轻女性尤其容易受到心血管疾病的影响 随着心肌梗塞发病率的上升，引起人们对潜在新疾病机制和风险的担忧 因素。社会心理压力被认为在冠状动脉疾病的发病机制中发挥着重要作用 这一弱势患者群体中的心肌梗死。与此同时，最近的研究表明 压力可能与男性和女性心血管疾病的差异模式有关，因为他们可能有 心血管应激倾向的不同发生率和机制。然而，关键的性别相关差异 生物标志物和机制仍然难以捉摸。因此，识别模式差异 精神和身体应激期间的心肌缺血将有助于更好地描述高危人群 人群，可能有助于理解精神应激期间心肌缺血的机制及其 与非阻塞性冠状动脉疾病的关系。在此应用程序中，我们将开发并使用一种新颖的 与冠状动脉造影相结合应用于静息/应激心肌灌注成像研究的算法 来自心肌梗死和精神压力 2 (MIMS-2) 数据库的结果，用于量化区域 心肌缺血的均匀性。目标 1 将比较心肌缺血的模式（局灶性与弥漫性） 男性和女性以及精神和身体压力期间。在目标 2 中，我们将调查 通过新算法量化的弥漫性轻度心肌缺血具有不良心血管结局。 拟议的分析将为了解弥漫性心肌缺血的影响提供合理的证据 血管段水平及其对冠状动脉功能和心肌血流的影响 与不良心血管结局的关联。此外，这项研究将提供一个使用的背景 我们对受试者的解释提高了我们对心肌缺血的易感性和 心肌缺血、精神应激与冠心病的关系。