title: Stress reduces diastolic function in youth.
abstract: OBJECTIVE
  Research regarding the influence of mental stress (MS) on heart function focused primarily on heart contractility. We hypothesized that MS results in attenuated diastolic function (DF) as early as in adolescence and this effect may differ by race and sex.
  
  
  METHODS
  161 normotensive adolescents (81 blacks and 80 females) performed resting (control) and MS (experimental) conditions on separate visits. Visits lasted for 3 hours (1-hour rest, video game challenge and recovery for experimental visit. Mitral inflow early (E) to late (A) filling velocities (E/A) ratio; mitral valve annular early velocity (E') and E/E' ratio were recorded every 30 minutes to evaluate DF.
  
  
  RESULTS
  BP and HR increased during experimental visit (all p values < .01). E/A ratio progressively increased during control visit (mean [SE], from 1.93 ± 0.42 to 2.01 ± 0.47) but decreased during the stress phase of experimental visit (from 1.91 ± 0.44 to 1.87 ± 0.50, p interaction < .001). In white males, E' increased from rest to stress phase (from 10.3 ± 2.55 to 10.7 ± 2.28 cm/s), whereas E' decreased in white females (from 11.0 ± 2.62 to 10.6 ± 2.53 cm/s), black males (from 10.5 ± 2.31 to 9.9 ± 2.19 cm/s), and black females (from 10.6 ± 2.22 to 10.3 ± 1.86 cm/s, p interaction < .04). During stress, higher A was associated with higher E/E' ratio.
  
  
  CONCLUSIONS
  Recurrent episodes of mental stress may increase the risk of poor DF, and these adverse effects may be stronger in females and black males.
authors: Georgia Prevention Institute, Department of Pediatrics, Georgia Health Sciences University, Augusta, GA 30912-4534. gkapuku@georgiahealth.edu
authors: Gaston K
authors: GK
authors: Kapuku
authors: Harry
authors: H
authors: Davis
authors: Kenneth
authors: K
authors: Murdison
authors: Vincent
authors: V
authors: Robinson
authors: Gregory
authors: G
authors: Harshfield
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D044383:Black People / Q000706:statistics & numerical data; D001783:Blood Flow Velocity / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D018592:Cross-Over Studies; D003971:Diastole / Q000502:physiology*; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012008:Recurrence; D012307:Risk Factors; D012727:Sex Characteristics; D017678:Sex Distribution; D013315:Stress, Psychological / Q000208:ethnology / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology; D044465:White People / Q000706:statistics & numerical data