Vlachopoulos Charalambos, Xaplanteris Panagiotis, Alexopoulos Nikolaos, Aznaouridis Konstantinos, Vasiliadou Carmen, Baou Katerina, Stefanadi Elli, Stefanadis Christodoulos
Peripheral Vessels Unit, 1st Cardiology Department, Athens Medical School, Hippokration Hospital, Athens, Greece.
Psychosom Med. 2009 May;71(4):446-53. doi: 10.1097/PSY.0b013e318198dcd4. Epub 2009 Feb 27.
To investigate the effect of laughter and mental stress on arterial stiffness and central hemodynamics. Arterial stiffness and wave reflections are independent predictors of cardiovascular risk. Chronic psychological stress is an independent risk factor for cardiovascular events, whereas acute stress deteriorates vascular function.
Eighteen healthy individuals were studied on three occasions, according to a randomized, single-blind, crossover, sham procedure-controlled design. The effects of viewing a 30-minute segment of two films inducing laughter or stress were assessed. Carotid-femoral pulse wave velocity was used as an index of arterial stiffness; augmentation index was used as a measure of wave reflections.
Laughter decreased pulse wave velocity (by 0.30 m/sec, p = .01), and augmentation index (by 2.72%, p = .05). Conversely, stress increased pulse wave velocity (by 0.29 m/sec, p = .05) and augmentation index (by 5.1%, p = .005). Laughter decreased cortisol levels by 1.67 microg/dl (p = .02), soluble P-selectin by 26 ng/ml (p = .02) and marginally von Willebrand factor (by 2.4%, p = .07) and increased total oxidative status (by 61 micromol/L, p < .001). Stress decreased interleukin-6 (by 0.11 pg/ml, p = .04) and increased total oxidative status (by 44 micromol/L, p = .007). Soluble CD40 ligand and fibrinogen remained unchanged.
Positive (laughter) and negative (stress) behavioral interventions have divergent acute effects on arterial stiffness and wave reflections. These findings have important clinical implications extending the spectrum of lifestyle modifications that can ameliorate arterial function.
探讨欢笑和精神压力对动脉僵硬度及中心血流动力学的影响。动脉僵硬度和波反射是心血管风险的独立预测因素。慢性心理压力是心血管事件的独立危险因素，而急性压力会使血管功能恶化。
按照随机、单盲、交叉、假手术对照设计，对18名健康个体进行了三次研究。评估观看两段分别引发欢笑或压力的30分钟影片片段的效果。使用颈股脉搏波速度作为动脉僵硬度指标；使用增强指数作为波反射的测量指标。
欢笑使脉搏波速度降低（降低0.30米/秒，p = 0.01），增强指数降低（降低2.72%，p = 0.05）。相反，压力使脉搏波速度增加（增加0.29米/秒，p = 0.05），增强指数增加（增加5.1%，p = 0.005）。欢笑使皮质醇水平降低1.67微克/分升（p = 0.02），可溶性P-选择素降低26纳克/毫升（p = 0.02），血管性血友病因子略有降低（降低2.4%，p = 0.07），并使总氧化状态增加（增加61微摩尔/升，p < 0.001）。压力使白细胞介素-6降低（降低0.11皮克/毫升，p = 0.04），并使总氧化状态增加（增加44微摩尔/升，p = 0.007）。可溶性CD40配体和纤维蛋白原保持不变。
积极（欢笑）和消极（压力）行为干预对动脉僵硬度和波反射有不同的急性影响。这些发现具有重要的临床意义，扩展了可改善动脉功能的生活方式改变的范围。
