Ventricular responses to mental stress testing in patients with coronary artery disease. Pathophysiological implications.
Recent research examining the effects of mental stress on left ventricular wall motion and/or ejection fraction has used four techniques to measure contractile function: radionuclide ventriculography, a stationary nuclear probe, two-dimensional echocardiography, and an ambulatory radionuclide left ventricular function monitor. This research has consistently revealed that mental stress-induced myocardial ischemia occurs frequently during laboratory stress testing, particularly among patients with exercise-induced ischemia. This ischemia is usually silent, occurs at low heart rate elevations but with significant blood pressure increases compared with exercise-induced ischemia, and is frequently not detected when electrocardiographic markers are used alone. Exploration of factors underlying differences between mental stress- and exercise-induced ischemia has provided a means for studying the complex pathophysiology of myocardial ischemia.
Rozanski
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Division of Cardiology, St. Luke's-Roosevelt Medical Center, New York, NY 10019.
Krantz
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DS
Bairey
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CN
D003327:Coronary Disease / Q000175:diagnosis / Q000523:psychology*; D004452:Echocardiography; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation; D009200:Myocardial Contraction / Q000502:physiology; D015635:Radionuclide Ventriculography / Q000295:instrumentation; D013315:Stress, Psychological / Q000503:physiopathology*; D013318:Stroke Volume / Q000502:physiology