Coronary and Peripheral Vasomotor Responses to Mental Stress
BackgroundCoronary microvascular dysfunction may contribute to myocardial ischemia during mental stress (MS). However, the role of coronary epicardial and microvascular function in regulating coronary blood flow (CBF) responses during MS remains understudied. We hypothesized that coronary vasomotion...
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2018
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oai:doaj.org-article:dcaefe309f1a43629ab0372a749df28d2021-11-12T17:02:01ZCoronary and Peripheral Vasomotor Responses to Mental Stress10.1161/JAHA.118.0085322047-9980https://doaj.org/article/dcaefe309f1a43629ab0372a749df28d2018-05-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.118.008532https://doaj.org/toc/2047-9980BackgroundCoronary microvascular dysfunction may contribute to myocardial ischemia during mental stress (MS). However, the role of coronary epicardial and microvascular function in regulating coronary blood flow (CBF) responses during MS remains understudied. We hypothesized that coronary vasomotion during MS is dependent on the coronary microvascular endothelial function and will be reflected in the peripheral microvascular circulation. Methods and ResultsIn 38 patients aged 59±8 years undergoing coronary angiography, endothelium‐dependent and endothelium‐independent coronary epicardial and microvascular responses were measured using intracoronary acetylcholine and nitroprusside, respectively, and after MS induced by mental arithmetic testing. Peripheral microvascular tone during MS was measured using peripheral arterial tonometry (Itamar Inc, Caesarea, Israel) as the ratio of digital pulse wave amplitude compared to rest (peripheral arterial tonometry ratio). MS increased the rate‐pressure product by 22% (±23%) and constricted epicardial coronary arteries by −5.9% (−10.5%, −2.6%) (median [interquartile range]), P=0.001, without changing CBF. Acetylcholine increased CBF by 38.5% (8.1%, 91.3%), P=0.001, without epicardial coronary diameter change (0.1% [−10.9%, 8.2%], P=not significant). The MS‐induced CBF response correlated with endothelium‐dependent CBF changes with acetylcholine (r=0.38, P=0.03) but not with the response to nitroprusside. The peripheral arterial tonometry ratio also correlated with the demand‐adjusted change in CBF during MS (r=−0.60, P=0.004), indicating similarity between the microcirculatory responses to MS in the coronary and peripheral microcirculation. ConclusionsThe coronary microvascular response to MS is determined by endothelium‐dependent, but not endothelium‐independent, coronary microvascular function. Moreover, the coronary microvascular responses to MS are reflected in the peripheral microvascular circulation.Muhammad HammadahJeong Hwan KimIbhar Al MheidAyman Samman TahhanKobina WilmotRonnie RamadanAyman AlkhoderMohamed KhayataGirum MekonnenOleksiy LevantsevychYasir BouchiBelal KaseerFahad ChoudharyMohamad M. GafeerFrank E. CorriganAmit J. ShahLaura WardMichael KutnerJ. Douglas BremnerDavid S. ShepsPaolo RaggiViola VaccarinoHabib SamadyKreton MavromatisArshed A. QuyyumiWileyarticleendothelial functionepicardialflowmental stressmicrovascularresistanceDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 7, Iss 10 (2018) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
endothelial function epicardial flow mental stress microvascular resistance Diseases of the circulatory (Cardiovascular) system RC666-701 |
| spellingShingle |
endothelial function epicardial flow mental stress microvascular resistance Diseases of the circulatory (Cardiovascular) system RC666-701 Muhammad Hammadah Jeong Hwan Kim Ibhar Al Mheid Ayman Samman Tahhan Kobina Wilmot Ronnie Ramadan Ayman Alkhoder Mohamed Khayata Girum Mekonnen Oleksiy Levantsevych Yasir Bouchi Belal Kaseer Fahad Choudhary Mohamad M. Gafeer Frank E. Corrigan Amit J. Shah Laura Ward Michael Kutner J. Douglas Bremner David S. Sheps Paolo Raggi Viola Vaccarino Habib Samady Kreton Mavromatis Arshed A. Quyyumi Coronary and Peripheral Vasomotor Responses to Mental Stress |
| description |
BackgroundCoronary microvascular dysfunction may contribute to myocardial ischemia during mental stress (MS). However, the role of coronary epicardial and microvascular function in regulating coronary blood flow (CBF) responses during MS remains understudied. We hypothesized that coronary vasomotion during MS is dependent on the coronary microvascular endothelial function and will be reflected in the peripheral microvascular circulation. Methods and ResultsIn 38 patients aged 59±8 years undergoing coronary angiography, endothelium‐dependent and endothelium‐independent coronary epicardial and microvascular responses were measured using intracoronary acetylcholine and nitroprusside, respectively, and after MS induced by mental arithmetic testing. Peripheral microvascular tone during MS was measured using peripheral arterial tonometry (Itamar Inc, Caesarea, Israel) as the ratio of digital pulse wave amplitude compared to rest (peripheral arterial tonometry ratio). MS increased the rate‐pressure product by 22% (±23%) and constricted epicardial coronary arteries by −5.9% (−10.5%, −2.6%) (median [interquartile range]), P=0.001, without changing CBF. Acetylcholine increased CBF by 38.5% (8.1%, 91.3%), P=0.001, without epicardial coronary diameter change (0.1% [−10.9%, 8.2%], P=not significant). The MS‐induced CBF response correlated with endothelium‐dependent CBF changes with acetylcholine (r=0.38, P=0.03) but not with the response to nitroprusside. The peripheral arterial tonometry ratio also correlated with the demand‐adjusted change in CBF during MS (r=−0.60, P=0.004), indicating similarity between the microcirculatory responses to MS in the coronary and peripheral microcirculation. ConclusionsThe coronary microvascular response to MS is determined by endothelium‐dependent, but not endothelium‐independent, coronary microvascular function. Moreover, the coronary microvascular responses to MS are reflected in the peripheral microvascular circulation. |
| format |
article |
| author |
Muhammad Hammadah Jeong Hwan Kim Ibhar Al Mheid Ayman Samman Tahhan Kobina Wilmot Ronnie Ramadan Ayman Alkhoder Mohamed Khayata Girum Mekonnen Oleksiy Levantsevych Yasir Bouchi Belal Kaseer Fahad Choudhary Mohamad M. Gafeer Frank E. Corrigan Amit J. Shah Laura Ward Michael Kutner J. Douglas Bremner David S. Sheps Paolo Raggi Viola Vaccarino Habib Samady Kreton Mavromatis Arshed A. Quyyumi |
| author_facet |
Muhammad Hammadah Jeong Hwan Kim Ibhar Al Mheid Ayman Samman Tahhan Kobina Wilmot Ronnie Ramadan Ayman Alkhoder Mohamed Khayata Girum Mekonnen Oleksiy Levantsevych Yasir Bouchi Belal Kaseer Fahad Choudhary Mohamad M. Gafeer Frank E. Corrigan Amit J. Shah Laura Ward Michael Kutner J. Douglas Bremner David S. Sheps Paolo Raggi Viola Vaccarino Habib Samady Kreton Mavromatis Arshed A. Quyyumi |
| author_sort |
Muhammad Hammadah |
| title |
Coronary and Peripheral Vasomotor Responses to Mental Stress |
| title_short |
Coronary and Peripheral Vasomotor Responses to Mental Stress |
| title_full |
Coronary and Peripheral Vasomotor Responses to Mental Stress |
| title_fullStr |
Coronary and Peripheral Vasomotor Responses to Mental Stress |
| title_full_unstemmed |
Coronary and Peripheral Vasomotor Responses to Mental Stress |
| title_sort |
coronary and peripheral vasomotor responses to mental stress |
| publisher |
Wiley |
| publishDate |
2018 |
| url |
https://doaj.org/article/dcaefe309f1a43629ab0372a749df28d |
| work_keys_str_mv |
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