Kinne G, Droste C, Fahrenberg J, Roskamm H
Herz-Zentrum (Heart Center), Bad Krozingen, Germany.
J Psychosom Res. 1999 Apr;46(4):369-77. doi: 10.1016/s0022-3999(98)00096-8.
In coronary heart disease (CHD), pathological myocardial ischemic changes do not always occur with the symptom of heart pain. Methodological problems make it difficult to examine the factors that influence silent and symptomatic myocardial ischemia in everyday life. This study uses a computer-assisted monitoring system with an interactive Holter ECG, an actometer, and an electronic diary. Self-report measurements indicate that symptomatic patients tend toward increased neuroticism, whereas asymptomatic patients engage in beneficial and active coping skills more frequently. The results of the monitoring study demonstrate the same degree of ischemia in silent and symptomatic episodes. However, these episodes show differences in certain psychological context variables. Symptomatic episodes are linked to high subjective strain and severe tension. Because angina pectoris is not a reliable warning signal of myocardial ischemia, the use of the interactive monitoring system is recommended for educating CHD patients on how to cope with excessive strain in everyday life.
在冠心病（CHD）中，病理性心肌缺血改变并不总是伴随着心痛症状出现。方法学上的问题使得在日常生活中难以研究影响无症状和有症状心肌缺血的因素。本研究使用了一个计算机辅助监测系统，该系统包括交互式动态心电图、活动计步器和电子日记。自我报告测量表明，有症状的患者往往神经质增加，而无症状的患者更频繁地采用有益和积极的应对技巧。监测研究结果表明，无症状和有症状发作时的缺血程度相同。然而，这些发作在某些心理背景变量上存在差异。有症状发作与高主观压力和严重紧张有关。由于心绞痛并非心肌缺血的可靠警示信号，因此建议使用交互式监测系统来指导冠心病患者如何应对日常生活中的过度压力。
