Vlachopoulos Charalambos, Kosmopoulou Foteini, Alexopoulos Nikolaos, Ioakeimidis Nikolaos, Siasos Gerasimos, Stefanadis Christodoulos
Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece.
Psychosom Med. 2006 Mar-Apr;68(2):231-7. doi: 10.1097/01.psy.0000203171.33348.72.
Large-artery stiffness and arterial wave reflections have been identified as independent markers and prognosticators of cardiovascular risk. Mental stress is a novel risk factor for coronary artery disease and has been associated with left ventricular dysfunction, myocardial ischemia and infarction, and sudden cardiac death. The purpose of this study was to assess the effect of acute mental stress on aortic stiffness and wave reflections.
The effect of a mental arithmetic test was assessed in 19 healthy individuals using a randomized, sham-procedure-controlled, crossover design. Carotid-femoral pulse wave velocity and augmentation index were measured as indices of aortic stiffness and wave reflections, respectively.
Mental stress induced a sustained increase in central systolic and pulse pressure throughout the whole study (systolic: by 7.5 mm Hg, p < .05; pulse: by 5.7 mm Hg, p < .01). The increase in peripheral systolic and pulse pressure was not significant throughout the study, but only when their peak values were compared with baseline (systolic: by 6.2 mm Hg, peak at 0 minutes; pulse: by 6.6 mm Hg, peak at 5 minutes, p < .05 for both). There was a sustained increase in pulse wave velocity (by 0.57 m/s, p < .005) throughout the study denoting a sustained increase in aortic stiffness. Similarly, augmentation index showed a sustained increase with mental stress (by 6.16%, p < .05) denoting increased wave reflections from the periphery.
Acute mental stress results in a prolonged increase in aortic stiffness and wave reflections. Given the important pathophysiologic and prognostic role of these parameters, our results provide important mechanistic links between acute mental stress and increased cardiovascular risk.
大动脉僵硬度和动脉波反射已被确定为心血管风险的独立标志物和预后指标。精神压力是冠心病的一种新的危险因素，与左心室功能障碍、心肌缺血和梗死以及心源性猝死有关。本研究的目的是评估急性精神压力对主动脉僵硬度和波反射的影响。
采用随机、假手术对照、交叉设计，对19名健康个体进行心算测试的效果评估。分别测量颈股脉搏波速度和增强指数作为主动脉僵硬度和波反射的指标。
在整个研究过程中，精神压力导致中心收缩压和脉压持续升高（收缩压：升高7.5 mmHg，p <.05；脉压：升高5.7 mmHg，p <.01）。外周收缩压和脉压在整个研究过程中升高不显著，但仅在将其峰值与基线值比较时显著（收缩压：升高6.2 mmHg，在0分钟时达到峰值；脉压：升高6.6 mmHg，在5分钟时达到峰值，两者p均<.05）。在整个研究过程中，脉搏波速度持续升高（升高0.57 m/s，p <.005），表明主动脉僵硬度持续增加。同样，增强指数随着精神压力持续升高（升高6.16%，p <.05），表明外周波反射增加。
急性精神压力导致主动脉僵硬度和波反射长时间增加。鉴于这些参数在病理生理和预后方面的重要作用，我们的结果为急性精神压力与心血管风险增加之间提供了重要的机制联系。
