title: Coronary endothelial dysfunction associated with a depressive mood in patients with atypical angina but angiographically normal coronary artery.
abstract: BACKGROUND
  Depression is a risk factor for the development of coronary heart disease but the relationship between coronary endothelial dysfunction and depression is not yet known. This study investigated whether depressive symptomatology is associated with coronary endothelial dysfunction in patients without coronary artery disease (CAD).
  
  
  RESULTS
  Incremental acetylcholine (Ach; 20, 50 and 100 microg/min) and nitrate (200 microg/min) were infused into the left coronary ostium of 52 patients (male 30, 51.8 years) with depressive symptoms as indicated by a Beck Depression Inventory (BDI) score of >or=10 and a Hamilton Depression Rating Scale (HAM-D17) of >or=7 but without overt CAD or any vasoactive medications. Vascular responses to each drug were measured quantitatively at the mid-segments of the left anterior descending artery (LAD) and compared to those of 103 matched control subjects (male 64, 51.3 years) with angiographically normal looking LAD and as estimated by BDI <10 and HAM-D17 <7. Patients in the depressive group showed significant vasoconstriction compared with patients in the non-depressive group (p=0.017, 0.090, 0.004 respectively). However, endothelium-independent vasodilatation to nitrates did not differ significantly between the two groups (p=0.461). No differences in risk factors were found between the two groups.
  
  
  CONCLUSIONS
  Depressive mood is associated with coronary endothelial dysfunction in patients without CAD, suggesting a possible mechanism by which depressive mood may act as a cardiovascular risk factor.
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, 97, Guro-dong, Guro-gu, Seoul, 152-703, Republic of Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Ko
authors.forename: Cheol Ung
authors.initials: CU
authors.lastname: Choi
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Na
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Chang Gyu
authors.initials: CG
authors.lastname: Park
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
mesh_terms: D000109:Acetylcholine / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000503:physiopathology*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000008:administration & dosage; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D014661:Vasoconstriction / Q000187:drug effects / Q000502:physiology; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D009566:Nitrates; D014665:Vasodilator Agents; D000109:Acetylcholine