Repolarization Changes Induced by Mental Stress in Normal Subjects and Patients with Coronary Artery Disease
Effect of Nitroglycerine
Bibliographic Data
| ID | 19304588 |
|---|---|
| Authors | Peter Taggart (0000-0001-8861-9227, University College Hospital, corresponding author), Velislav N Batchvarov, Peter Sutton, Geoff Young, Sharon Young (0000-0001-5771-5558), David Patterson (0000-0002-4042-1366), David J Patterson (0000-0003-2645-7335) |
| Year | 2009 |
| Volume | 71 |
| Issue | 1 |
| Pages | 23-29 |
| Publication date | 2009-01-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Psychosomatic Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0033-3174 • E-ISSN: 1534-7796 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/psy.0b013e31818a1d56 |
| PMID | 19124615 |
| OpenAlex | W1970113963 |
| Language | EN |
| References cited | 32 |
OBJECTIVES: Mental stress can significantly affect ventricular repolarization, which could potentially trigger arrhythmias. We compared the effect of mental stress on repolarization indexed by the amplitude and area of the T wave in patients with coronary artery disease (CAD) and healthy subjects. METHODS: Fourteen healthy controls (11 M, mean age 42 years) and 14 patients with stable CAD (12 M, mean age 64) underwent a mental stress protocol consisting of mental arithmetic followed by a speech (5 minutes each), which was performed on two occasions following either nitroglycerine (NTG) or placebo. Multiple 12-lead electrocardiograms were acquired and repolarization was analyzed using automatically measured T wave amplitude (T(amp)) and area (T(area)). RESULTS: When preceded by placebo the overall effect of mental stress, whether induced by arithmetic or speech, was significantly different in CAD patients compared with controls, with a decrease in T(amp) and T(area) in controls and an increase in patients; e.g., change in T(amp) during arithmetic -20 +/- 3 microV in controls versus 4 +/- 2 microV in patients, p < .001, and during speech -9 +/- 3 microV in controls versus 7 +/- 1 microV in patients, p < .001. Following NTG, the effect of stress on repolarization was similar in the 2 groups, with a reversed effect, i.e., decrease instead of increase in T(amp) and T(area) in CAD patients. CONCLUSIONS: The effect of mental stress on ventricular repolarization is significantly different in CAD patients compared with healthy controls. These differences are considerably reduced by NTG
Anesthesia · Cardiology · Coronary artery disease · Electrophysiology · Mental stress · Pathology · Placebo · Repolarization · Ventricular Repolarization · Cardiac electrophysiology and arrhythmias · ECG Monitoring and Analysis · Internal Medicine · Medicine · Takotsubo Cardiomyopathy and Associated Phenomena
| Highly cited | No |
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