Department of Cardiology, Xiyuan Hospital, Cardiovascular Disease Center, Chinese Academy of Traditional Chinese Medicine; Beijing-China.
Department of Gynecology of Traditional Chinese Medicine, China-Japan Friendship Hospital; Beijing-China.
Anatol J Cardiol. 2020 Sep;24(3):126-136. doi: 10.14744/AnatolJCardiol.2020.69447.
Myocardial ischemia resulting from psychological stress [mental stress-induced myocardial ischemia (MSIMI)] refers to the condition wherein psychosocial and psychological stimulations cause myocardial ischemia in patients with coronary heart disease, which is different from drug-induced myocardial ischemia. Therefore, this condition often escapes diagnosis, portends clinical risk, and affects the quality of life of MSIMI survivors. MSIMI is closely related to the poor prognosis of cardiovascular diseases, especially in young women, according to recent randomized, controlled trials (RCTs) on MSIMI. These RCTs involved different sample sizes, interventional measures, and detection techniques. Moreover, differences exist regarding the prevalence rate, distribution characteristics, possible pathogenesis, and clinical significance. Nevertheless, currently, the diagnostic criteria, pathogenesis, and treatment of MSIMI are still in the clinical exploration stage. Hence, considering recent RCTs, this paper summarizes the research status of MSIMI from the aspects of pathogenesis, diagnosis, and treatment strategies to provide a theoretical basis for the follow-up diagnostic methods and treatment guidelines for MSIMI.
心理应激导致的心肌缺血（精神应激诱导性心肌缺血，MSIMI）是指在冠心病患者中心理社会和心理刺激引起的心肌缺血，不同于药物引起的心肌缺血。因此，这种情况常常被漏诊，预示着临床风险，并影响 MSIMI 幸存者的生活质量。根据最近对 MSIMI 的随机对照试验（RCT），MSIMI 与心血管疾病的不良预后密切相关，尤其是在年轻女性中。这些 RCT 涉及不同的样本量、干预措施和检测技术。此外，在流行率、分布特征、可能的发病机制和临床意义方面也存在差异。然而，目前 MSIMI 的诊断标准、发病机制和治疗仍处于临床探索阶段。因此，考虑到最近的 RCT，本文从发病机制、诊断和治疗策略等方面总结了 MSIMI 的研究现状，为 MSIMI 的后续诊断方法和治疗指南提供了理论依据。
