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Author Notes:

Corresponding authors at: Emory University, Department of Cardiology, Emory University School of medicine, 1462 Clifton Road N.E. Suite 507, Atlanta GA 30322. lvaccar@emory.edu (V. Vaccarino), aquyyum@emory.edu (A.A. Quyyumi).

These authors contributed equally to this work and should be both considered first authors: Muhammad Hammadah and Samaah Sullivan.

Dr. Vaccarino and Dr. Quyyumi report research support from NIH.

Ernest V. Garcia receives royalties from the sale of the Emory Cardiac Toolbox, used for some analyses in this study.

None of the other authors report conflict of interest relevant to this article.

Subjects:

Research Funding:

This work was supported by the NIH (P01 HL101398, P20HL113451-01, P01HL086773-06A1, R56HL126558-01, R01 HL109413, R01HL109413-02S1, R01 HL125246, UL1TR000454, KL2TR000455, K24HL077506, K24 MH076955, and THL130025A).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Neurosciences
  • Psychiatry
  • Neurosciences & Neurology
  • Inflammation
  • Mental stress
  • Myocardial ischemia
  • C reactive protein
  • Interleukin 6
  • Matrix metallopeptidase 9
  • Monocyte chemoattractant protein-1
  • CORONARY-ARTERY-DISEASE
  • C-REACTIVE PROTEIN
  • ACUTE PSYCHOLOGICAL STRESS
  • MAJOR DEPRESSIVE DISORDER
  • ENDOTHELIAL DYSFUNCTION
  • CARDIOVASCULAR-DISEASE
  • UNSTABLE ANGINA
  • OLDER MEN
  • INTERLEUKIN-6
  • INFARCTION

Inflammatory response to mental stress and mental stress induced myocardial ischemia

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Journal Title:

Brain, Behavior, and Immunity

Volume:

Volume 68

Publisher:

, Pages 90-97

Type of Work:

Article | Post-print: After Peer Review

Abstract:

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.

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© 2017

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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