title: Effects of anger on left ventricular ejection fraction in coronary artery disease.
abstract: This study examined the comparative potency of several psychological stressors and exercise in eliciting myocardial ischemia as measured by left ventricular (LV) ejection fraction (EF) changes using radionuclide ventriculography. Twenty-seven subjects underwent both exercise (bicycle) and psychological stressors (mental arithmetic, recall of an incident that elicited anger, giving a short speech defending oneself against a charge of shoplifting) during which EF, blood pressure, heart rate and ST segment were measured. Eighteen subjects had 1-vessel coronary artery disease (CAD), defined by greater than 50% diameter stenosis in 1 artery as assessed by arteriography. Nine subjects served as healthy control subjects. Anger recall reduced EF more than exercise and the other psychological stressors (overall F [3.51] = 2.87, p = .05). Respective changes in EF for the CAD patients were -5% during anger recall, +2% during exercise, 0% during mental arithmetic and 0% during the speech stressor. More patients with CAD had significant reduction in EF (greater than or equal to 7%) during anger (7 of 18) than during exercise (4 of 18). The difference in EF change between patients with CAD and healthy control subjects was significant for both anger (t25 = 2.23, p = 0.04) and exercise (t25 = 2.63, p = 0.01) stressors. In this group of patients with CAD, anger appeared to be a particularly potent psychological stressor.
authors.affiliation: Department of Psychology, University of Miami, Coral Gables.
authors.forename: G
authors.initials: G
authors.lastname: Ironson
authors.forename: C B
authors.initials: CB
authors.lastname: Taylor
authors.forename: M
authors.initials: M
authors.lastname: Boltwood
authors.forename: T
authors.initials: T
authors.lastname: Bartzokis
authors.forename: C
authors.initials: C
authors.lastname: Dennis
authors.forename: M
authors.initials: M
authors.lastname: Chesney
authors.forename: S
authors.initials: S
authors.lastname: Spitzer
authors.forename: G M
authors.initials: GM
authors.lastname: Segall
mesh_terms: D000786:Anger / Q000502:physiology*; D001007:Anxiety / Q000503:physiopathology; D001794:Blood Pressure; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology*; D004562:Electrocardiography; D005080:Exercise Test; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D015635:Radionuclide Ventriculography; D013315:Stress, Psychological / Q000503:physiopathology; D013318:Stroke Volume