Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Warandelaan 2, P.O. Box 90153, 5037 AB, Tilburg, The Netherlands.
Department of Cardiology, Elizabeth-TweeSteden Hospital, Tilburg, The Netherlands.
J Nucl Cardiol. 2021 Dec;28(6):2581-2592. doi: 10.1007/s12350-020-02079-3. Epub 2020 Feb 28.
The prevalence of myocardial ischemia is associated with anxiety. State and trait anxiety are more common in younger women compared to men, and high anxiety levels could affect hemodynamic reactivity during cardiac stress testing. The aim is to examine whether anxiety plays a role in gender differences in patients ≤ 65 and > 65 years in hemodynamic reactivity and ischemia during cardiac stress testing.
Included were 291 patients (66.8 ± 8.7 years, 45% women) with suspect ischemia undergoing myocardial perfusion single-photon emission computed tomography (MPI-SPECT). Primary outcomes were semi-quantitative summed difference score (SDS) and summed stress score (SSS), as continuous indicators of myocardial ischemia. Analyses were stratified by age. Trait anxiety was measured using a validated questionnaire (GAD-7) and state anxiety using facial expression analyses software. Overall, trait and state anxiety were not associated with the prevalence of ischemia (N = 107, 36%). A significant interaction was found between gender and trait anxiety in women ≤ 65 years for SDS (F(1,4) = 5.73, P = .019) and SSS (F(1,10) = 6.50, P = .012). This was not found for state anxiety.
SDS and SSS were significantly higher in women younger than 65 years with high trait anxiety. This interaction was not found in men and women over 65 years.
心肌缺血的患病率与焦虑有关。与男性相比，状态焦虑和特质焦虑在年轻女性中更为常见，而高焦虑水平可能会影响心脏应激测试期间的血液动力学反应。目的是研究焦虑是否在 ≤ 65 岁和 > 65 岁的患者的心脏应激测试中对血液动力学反应和缺血的性别差异中起作用。
共纳入 291 名可疑缺血的患者（66.8 ± 8.7 岁，45%为女性）进行心肌灌注单光子发射计算机断层扫描（MPI-SPECT）。主要结局是半定量总和差评分（SDS）和总和应激评分（SSS），作为心肌缺血的连续指标。分析按年龄分层。特质焦虑采用经过验证的问卷（GAD-7）进行测量，状态焦虑采用面部表情分析软件进行测量。总体而言，特质焦虑和状态焦虑与缺血的患病率（N = 107，36%）无关。在 ≤ 65 岁的女性中，特质焦虑与性别之间存在显著的交互作用，SDS（F(1,4) = 5.73，P = .019）和 SSS（F(1,10) = 6.50，P = .012）。状态焦虑则没有这种情况。
在特质焦虑较高的 <65 岁女性中，SDS 和 SSS 明显较高。这种交互作用在 65 岁以上的男性和女性中没有发现。
