Krantz D S, Kop W J, Santiago H T, Gottdiener J S
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Cardiol Clin. 1996 May;14(2):271-87.
Recent research on the effects of behavioral activities on myocardial ischemia in coronary artery disease patients has provided a pathophysiologic model for understanding the mechanisms by which mental stress can trigger clinical cardiovascular events. This article reviews epidemiologic research implicating psychosocial stress as an acute trigger of myocardial infarction in patients with pre-existing coronary artery disease, and evidence for the pathophysiologic effects of acute mental stress in individuals with pre-existing coronary artery disease. Via its actions on the central and autonomic nervous systems, stress can produce a cascade of physiologic responses in vulnerable individuals that may lead to myocardial ischemia, ventricular fibrillation, plaque rupture, or coronary thrombosis. Also reviewed are field and laboratory studies that suggest important causal links between mental stress and myocardial ischemia, and evidence suggesting clinical significance for vulnerability to mental stress-induced ischemia.
近期关于行为活动对冠心病患者心肌缺血影响的研究，为理解精神压力引发临床心血管事件的机制提供了一个病理生理模型。本文综述了流行病学研究，这些研究表明社会心理压力是已有冠心病患者心肌梗死的急性触发因素，以及急性精神压力对已有冠心病患者病理生理影响的证据。通过对中枢和自主神经系统的作用，压力可在易患个体中引发一系列生理反应，这些反应可能导致心肌缺血、心室颤动、斑块破裂或冠状动脉血栓形成。还综述了一些实地研究和实验室研究，这些研究表明精神压力与心肌缺血之间存在重要的因果联系，以及表明对精神压力诱导的缺血易感性具有临床意义的证据。
