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疑似冠心病患者 SPECT 影像检查中心理因素分析。

Psychological factors of suspect coronary microvascular dysfunction in patients undergoing SPECT imaging.

机构信息

Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.

Department of Nuclear Medicine, Institute Verbeeten, Tilburg, The Netherlands.

出版信息

J Nucl Cardiol. 2022 Apr;29(2):768-778. doi: 10.1007/s12350-020-02360-5. Epub 2020 Oct 6.

Abstract

BACKGROUND

Patients with myocardial ischemia in the absence of obstructive coronary artery disease (CAD) often experience anginal complaints and are at risk of cardiac events. Stress-related psychological factors and acute negative emotions might play a role in these patients with suspect coronary microvascular dysfunction (CMD).

METHODS AND RESULTS

295 Patients (66.9 ± 8.7 years, 46% women) undergoing myocardial perfusion single-photon-emission computed tomography (MPI-SPECT), were divided as follows: (1) a non-ischemic reference group (n = 136); (2) patients without inducible ischemia, but with a history of CAD (n = 62); (3) ischemia and documented CAD (n = 52); and (4) ischemia and suspect CMD (n = 45). These four groups were compared with regard to psychological factors and acute emotions. Results revealed no differences between the groups in psychological factors (all P > .646, all effect sizes d < .015). State sadness was higher for patients with suspect CMD (16%) versus the other groups (P = .029). The groups did not differ in the association of psychological factors or emotions with anginal complaints (all P values > .448).

CONCLUSION

Suspect CMD was not associated with more negative psychological factors compared to other groups. State sadness was significantly higher for patients with suspect CMD, whereas no differences in state anxiety and other psychological factors were found.

摘要

背景

患有非阻塞性冠状动脉疾病(CAD)心肌缺血的患者常出现心绞痛症状,并存在心脏事件风险。应激相关心理因素和急性负面情绪可能在这些疑似冠状动脉微血管功能障碍(CMD)的患者中起作用。

方法和结果

295 名(66.9±8.7 岁,46%为女性)接受心肌灌注单光子发射计算机断层扫描(MPI-SPECT)的患者分为以下四组:(1)非缺血参考组(n=136);(2)无诱发性缺血但有 CAD 病史的患者(n=62);(3)缺血和确诊 CAD 的患者(n=52);(4)缺血和疑似 CMD 的患者(n=45)。比较这四组的心理因素和急性情绪。结果显示,心理因素在各组之间无差异(所有 P>.646,所有效应大小 d<.015)。与其他组相比,疑似 CMD 患者的状态悲伤更高(16% vs. 其他组,P=.029)。心理因素或情绪与心绞痛症状的关联在各组之间无差异(所有 P 值>.448)。

结论

与其他组相比,疑似 CMD 与更多负面心理因素无关。疑似 CMD 患者的状态悲伤显著更高,而状态焦虑和其他心理因素无差异。

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