Jacob P Feigal1, Stephen H Boyle2, Zainab Samad3, Eric J Velazquez3, Jennifer L Wilson2, Richard C Becker3, Redford B Williams2, Cynthia M Kuhn4, Thomas L Ortel3, Joseph G Rogers3, Christopher M O'Connor3, Wei Jiang5. 1. Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, United States; Department of Medicine, Duke University Medical Center, Durham, NC, United States. 2. Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, United States. 3. Department of Medicine, Duke University Medical Center, Durham, NC, United States. 4. Department of Pharmacology & Cancer Biology, Duke University, Durham, NC, United States. 5. Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, United States; Department of Medicine, Duke University Medical Center, Durham, NC, United States. Electronic address: jiang001@mc.duke.edu.
Abstract
OBJECTIVE: Depressive symptoms have been associated with myocardial ischemia induced by mental (MSIMI) and exercise (ESIMI) stress in clinically stable ischemic heart disease (IHD) patients, but the association between positive emotions and inducible ischemia is less well characterized. The objective of this study was to examine the associations between ratings of well-being and stress-induced ischemia. METHODS: Subjects were adult patients with documented IHD underwent mental and exercise stress testing for the Responses of Myocardial Ischemia to Escitalopram Treatment (REMIT) trial. The General Well-Being Schedule (GWBS), with higher scores reflecting greater subjective well-being, and the Center for Epidemiologic Studies Depression Scale (CES-D) were obtained from the REMIT participants. Echocardiography was used to measure ischemic responses to mental stress and Bruce protocol treadmill exercise testing. Data were analyzed using logistic regression adjusting for age, sex, resting left-ventricular ejection fraction (LVEF), and resting wall motion score index, as well as health-related behaviors. RESULTS: GWBS scores were obtained for 210 individuals, with MSIMI present in 92 (43.8%) and ESIMI present in 64 (30.5%). There was a significant inverse correlation between GWBS-PE (Positive Emotion subscale) scores and probability of ESIMI (OR=0.55 (95%CI 0.36-0.83), p=0.005). This association persisted after additional control for CESD subscales measuring negative and positive emotions and for variables reflecting health-related behaviors. A similar inverse correlation between GWBS-PE and MSIMI was observed, but did not reach statistical significance (OR=0.81 (95%CI 0.54-1.20), p=0.28). CONCLUSION: This is, to our knowledge, the first study demonstrating that greater levels of self-reported positive emotions are associated with a lower likelihood of ESIMI among patients with known IHD. Our results highlight the important interface functions of the central nervous and cardiovascular systems and underscore areas for future investigation.
OBJECTIVE:Depressive symptoms have been associated with myocardial ischemia induced by mental (MSIMI) and exercise (ESIMI) stress in clinically stable ischemic heart disease (IHD) patients, but the association between positive emotions and inducible ischemia is less well characterized. The objective of this study was to examine the associations between ratings of well-being and stress-induced ischemia. METHODS: Subjects were adult patients with documented IHD underwent mental and exercise stress testing for the Responses of Myocardial Ischemia to Escitalopram Treatment (REMIT) trial. The General Well-Being Schedule (GWBS), with higher scores reflecting greater subjective well-being, and the Center for Epidemiologic Studies Depression Scale (CES-D) were obtained from the REMIT participants. Echocardiography was used to measure ischemic responses to mental stress and Bruce protocol treadmill exercise testing. Data were analyzed using logistic regression adjusting for age, sex, resting left-ventricular ejection fraction (LVEF), and resting wall motion score index, as well as health-related behaviors. RESULTS:GWBS scores were obtained for 210 individuals, with MSIMI present in 92 (43.8%) and ESIMI present in 64 (30.5%). There was a significant inverse correlation between GWBS-PE (Positive Emotion subscale) scores and probability of ESIMI (OR=0.55 (95%CI 0.36-0.83), p=0.005). This association persisted after additional control for CESD subscales measuring negative and positive emotions and for variables reflecting health-related behaviors. A similar inverse correlation between GWBS-PE and MSIMI was observed, but did not reach statistical significance (OR=0.81 (95%CI 0.54-1.20), p=0.28). CONCLUSION: This is, to our knowledge, the first study demonstrating that greater levels of self-reported positive emotions are associated with a lower likelihood of ESIMI among patients with known IHD. Our results highlight the important interface functions of the central nervous and cardiovascular systems and underscore areas for future investigation.
Authors: Jingkai Wei; Cherie Rooks; Ronnie Ramadan; Amit J Shah; J Douglas Bremner; Arshed A Quyyumi; Michael Kutner; Viola Vaccarino Journal: Am J Cardiol Date: 2014-05-01 Impact factor: 2.778
Authors: N B Schiller; P M Shah; M Crawford; A DeMaria; R Devereux; H Feigenbaum; H Gutgesell; N Reichek; D Sahn; I Schnittger Journal: J Am Soc Echocardiogr Date: 1989 Sep-Oct Impact factor: 5.251
Authors: Wei Jiang; Michael A Babyak; Alan Rozanski; Andrew Sherwood; Christopher M O'Connor; Robert A Waugh; R Edward Coleman; Michael W Hanson; James J Morris; James A Blumenthal Journal: Am Heart J Date: 2003-07 Impact factor: 4.749
Authors: Mauro Giovanni Carta; Andrea Norcini Pala; Gabriele Finco; Mario Musu; Maria Francesca Moro Journal: Clin Pract Epidemiol Ment Health Date: 2015-02-27
Authors: Maria T Bekendam; Ilse A C Vermeltfoort; Willem J Kop; Jos W Widdershoven; Paula M C Mommersteeg Journal: J Nucl Cardiol Date: 2020-10-06 Impact factor: 5.952