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Impaired brachial artery endothelial function in young healthy women following an acute painful stimulus

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Abstract

Introduction

Impaired endothelial function has been observed during and immediately following an acutely painful stimulus. However, the extent to which this persists following pain dissipation is unclear.

Purpose

To determine whether painful ischemic handgrip exercise (pain task) causes impaired flow-mediated dilation (FMD) after the sensation of pain and hemodynamic responses have abated. A second purpose was to determine whether the response to pain differed with a predisposition to magnify, ruminate, and feel helpless about pain (pain catastrophizing status).

Methods

Brachial artery FMD stimulated by reactive hyperemia was assessed via ultrasound in 18 (9 high catastrophizing) healthy, women (20 ± 1 years) before and 15 min after a 3 min pain task. The shear stress stimulus for FMD was estimated as shear rate (blood velocity/brachial artery diameter).

Results (mean ± SD)

None of the variables were significantly impacted by pain catastrophizing status and are presented pooled across group. The pain task increased pain ratings [1 ± 1–6 ± 3 (0–10 scale) (p < 0.001)], mean arterial pressure (MAP) (p < 0.001) and heart rate (HR) (p < 0.001), all returning to pre-pain levels ≤2-min post-pain task (pre-pain vs. 2-min post-pain: pain rating p = 1.000; MAP p = 0.142; HR p = 0.992). The shear rate stimulus was not different between pre- and post-pain task FMD tests (p = 0.200). FMD decreased post-pain task (10.8 ± 4.6 vs. 7.0 ± 2.7 %, p < 0.001).

Conclusion

These results indicate that, regardless of pain catastrophizing status, painful ischemic handgrip exercise has a deleterious impact on endothelial function that persists after the pain sensation and hemodynamic responses have abated.

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Abbreviations

ANOVA:

Analysis of variance

AUC:

Area under the curve

FMD:

Flow-mediated dilation

HR:

Heart rate

IL:

Interleukin

MAP:

Mean arterial pressure

References

  • Broadley AJ, Korszun A, Abdelaal E, Moskvina V, Jones CJ, Nash GB, Ray C, Deanfield J, Frenneaux MP (2005) Inhibition of cortisol production with metyrapone prevents mental stress-induced endothelial dysfunction and baroreflex impairment. J Am Coll Cardiol 46:344–350

    Article  CAS  PubMed  Google Scholar 

  • Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, Lloyd JK, Deanfield JE (1992) Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 340:1111–1115

    Article  CAS  PubMed  Google Scholar 

  • Duffy SJ, Castle SF, Harper RW, Meredith IT (1999) Contribution of vasodilator prostanoids and nitric oxide to resting flow, metabolic vasodilation, and flow-mediated dilation in human coronary circulation. Circulation 100:1951–1957

    Article  CAS  PubMed  Google Scholar 

  • Dyson KS, Shoemaker JK, Hughson RL (2006) Effect of acute sympathetic nervous system activation on flow-mediated dilation of brachial artery. Am J Physiol Heart Circ Physiol 290:H1446–H1453

    Article  CAS  PubMed  Google Scholar 

  • Edwards RR, Kronfli T, Haythornthwaite JA, Smith MT, McGuire L, Page GG (2008) Association of catastrophizing with interleukin-6 responses to acute pain. Pain 140:135–144

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • George SZ, Dannecker EA, Robinson ME (2006) Fear of pain, not pain catastrophizing, predicts acute pain intensity, but neither factor predicts tolerance or blood pressure reactivity: an experimental investigation in pain-free individuals. Eur J Pain 10:457–465

    Article  PubMed  Google Scholar 

  • Ghiadoni L, Donald AE, Cropley M, Mullen MJ, Oakley G, Taylor M, O’Connor G, Betteridge J, Klein N, Steptoe A, Deanfield JE (2000) Mental stress induces transient endothelial dysfunction in humans. Circulation 102:2473–2478

    Article  CAS  PubMed  Google Scholar 

  • Gilliam W, Burns JW, Quartana P, Matsuura J, Nappi C, Wolff B (2010) Interactive effects of catastrophizing and suppression on responses to acute pain: a test of an appraisal × emotion regulation model. J Behav Med 33:191–199

    Article  PubMed Central  PubMed  Google Scholar 

  • Gracely RH, Geisser ME, Giesecke T, Grant MA, Petzke F, Williams DA, Clauw DJ (2004) Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 127:835–843

    Article  CAS  PubMed  Google Scholar 

  • Harris KF, Matthews KA (2004) Interactions between autonomic nervous system activity and endothelial function: a model for the development of cardiovascular disease. Psychosom Med 66:153–164

    Article  PubMed  Google Scholar 

  • Harris CW, Edwards JL, Baruch A, Riley WA, Pusser BE, Rejeski WJ, Herrington DM (2000) Effects of mental stress on brachial artery flow-mediated vasodilation in healthy normal individuals. Am Heart J 139:405–411

    CAS  PubMed  Google Scholar 

  • Harris RA, Padilla J, Rink LD, Wallace JP (2006) Variability of flow-mediated dilation measurements with repetitive reactive hyperemia. Vasc Med 11:1–6

    Article  PubMed  Google Scholar 

  • Hijmering ML, Stroes ES, Olijhoek J, Hutten BA, Blankestijn PJ, Rabelink TJ (2002) Sympathetic activation markedly reduces endothelium-dependent, flow-mediated vasodilation. J Am Coll Cardiol 39:683–688

    Article  PubMed  Google Scholar 

  • Hingorani AD, Cross J, Kharbanda RK, Mullen MJ, Bhagat K, Taylor M, Donald AE, Palacios M, Griffin GE, Deanfield JE, MacAllister RJ, Vallance P (2000) Acute systemic inflammation impairs endothelium-dependent dilatation in humans. Circulation 102:994–999

    Article  CAS  PubMed  Google Scholar 

  • Jacobs DR Jr, Ainsworth BE, Hartman TJ, Leon AS (1993) A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 25:81–91

    Article  PubMed  Google Scholar 

  • Jambrik Z, Santarcangelo EL, Rudisch T, Varga A, Forster T, Carli G (2005) Modulation of pain-induced endothelial dysfunction by hypnotisability. Pain 116:181–186

    Article  PubMed  Google Scholar 

  • Jazuli F, Pyke KE (2010) No Evidence of systematic changes in brachial artery FMD with repeated increase in shear stress. Med Sci Sports Exerc 42(5):310

    Article  Google Scholar 

  • Jazuli F, Pyke KE (2011) The impact of baseline artery diameter on flow-mediated vasodilation: a comparison of brachial and radial artery responses to matched levels of shear stress. Am J Physiol Heart Circ Physiol 301:H1667–H1677

    Article  CAS  PubMed  Google Scholar 

  • Landmesser U, Hornig B, Drexler H (2004) Endothelial function: a critical determinant in atherosclerosis? Circulation 109:II27–II33

    Article  PubMed  Google Scholar 

  • Lee YC, Lu B, Bathon JM, Haythornthwaite JA, Smith MT, Page GG, Edwards RR (2011) Pain sensitivity and pain reactivity in osteoarthritis. Arthritis Care Res 63:320–327

    Google Scholar 

  • Lind L, Johansson K, Hall J (2002) The effects of mental stress and the cold pressure test on flow-mediated vasodilation. Blood Press 11:22–27

    Article  PubMed  Google Scholar 

  • McBeth J, Symmons DP, Silman AJ, Allison T, Webb R, Brammah T, Macfarlane GJ (2009) Musculoskeletal pain is associated with a long-term increased risk of cancer and cardiovascular-related mortality. Rheumatology 48:74–77

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • McGrath PA (1994) Psychological aspects of pain perception. Arch Oral Biol 39(Suppl):55S–62S

    Article  PubMed  Google Scholar 

  • Padilla J, Harris RA, Fly AD, Rink LD, Wallace JP (2006) A comparison between active- and reactive-hyperaemia-induced brachial artery vasodilation. Clin Sci 110:387–392

    Article  PubMed  Google Scholar 

  • Padilla J, Young CN, Simmons GH, Deo SH, Newcomer SC, Sullivan JP, Laughlin MH, Fadel PJ (2010) Increased muscle sympathetic nerve activity acutely alters conduit artery shear rate patterns. Am J Physiol Heart Circ Physiol 298:H1128–H1135

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Poitras VJ, Pyke KE (2013) The impact of acute mental stress on vascular endothelial function: evidence, mechanisms and importance. Int J Psychophysiol 88:124–135

    Article  PubMed  Google Scholar 

  • Pontari MA, Naughton-Collins M, O’leary MP, Calhoun EA, Jang T, Kusek JW, Landis JR, Knauss J, Litwin MS (2005) A case-control study of risk factors in men with chronic pelvic pain syndrome. BJU Int 96:559–565

    Article  PubMed  Google Scholar 

  • Pyke KE, Hartnett JA, Tschakovsky ME (2008) Are the dynamic response characteristics of brachial artery flow mediated dilation sensitive to the magnitude of increase in shear stimulus? J Appl Physiol 105:282–292

    Article  CAS  PubMed  Google Scholar 

  • Schlereth T, Birklein F (2008) The sympathetic nervous system and pain. Neuromolecular Med 10:141–147

    Article  CAS  PubMed  Google Scholar 

  • Schobel HP, Ringkamp M, Behrmann A, Forster C, Schmieder RE, Handwerker HO (1996) Hemodynamic and sympathetic nerve responses to painful stimuli in normotensive and borderline hypertensive subjects. Pain 66:117–124

    Article  CAS  PubMed  Google Scholar 

  • Schommer NC, Hellhammer DH, Kirschbaum C (2003) Dissociation between reactivity of the hypothalamus–pituitary–adrenal axis and the sympathetic–adrenal–medullary system to repeated psychosocial stress. Psychosom Med 65:450–460

    Article  CAS  PubMed  Google Scholar 

  • Severeijns R, Vlaeyen JW, van den Hout MA, Weber WE (2001) Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain 17:165–172

    Article  CAS  PubMed  Google Scholar 

  • Spieker LE, Hurlimann D, Ruschitzka F, Corti R, Enseleit F, Shaw S, Hayoz D, Deanfield JE, Luscher TF, Noll G (2002) Mental stress induces prolonged endothelial dysfunction via endothelin-A receptors. Circulation 105:2817–2820

    Article  CAS  PubMed  Google Scholar 

  • Sullivan M, Bishop SR, Pivik J (1995) The pain catastrophizing scale: development and validation. Psychol Assess 7:524–532

    Article  Google Scholar 

  • Szijgyarto IC, King TJ, Ku J, Poitras VJ, Gurd BJ, Pyke KE (2013) The impact of acute mental stress on brachial artery flow-mediated dilation differs when shear stress is elevated by reactive hyperemia versus handgrip exercise. Appl Physiol Nutr Metab 38:498–506

    Article  CAS  PubMed  Google Scholar 

  • Szijgyarto IC, Poitras VJ, Gurd BJ, Pyke KE (2014) Acute psychological and physical stress transiently enhances brachial artery flow-mediated dilation stimulated by exercise-induced increases in shear stress. Appl Physiol Nutr Metab 39:927–936

    Article  PubMed  Google Scholar 

  • Thijssen DH, Dawson EA, Tinken TM, Cable NT, Green DJ (2009) Retrograde flow and shear rate acutely impair endothelial function in humans. Hypertension 53:986–992

    Article  CAS  PubMed  Google Scholar 

  • Thijssen DH, Black MA, Pyke KE, Padilla J, Atkinson G, Harris RA, Parker B, Widlansky ME, Tschakovsky ME, Green DJ (2011) Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol 300:H2–12

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Torrance N, Elliott AM, Lee AJ, Smith BH (2010) Severe chronic pain is associated with increased 10 year mortality. A cohort record linkage study. Eur J Pain 14:380–386

    Article  PubMed  Google Scholar 

  • Tripp DA, Nickel JC, Wang Y, Litwin MS, McNaughton-Collins M, Landis JR, Alexander RB, Schaeffer AJ, O’leary MP, Pontari MA, Fowler JE Jr, Nyberg LM, Kusek JW (2006) Catastrophizing and pain-contingent rest predict patient adjustment in men with chronic prostatitis/chronic pelvic pain syndrome. J Pain 7:697–708

    Article  PubMed  Google Scholar 

  • Vita JA, Hamburg NM (2010) Does endothelial dysfunction contribute to the clinical status of patients with peripheral arterial disease? Can J Cardiol 26(Suppl A):45A–50A

    Article  CAS  PubMed  Google Scholar 

  • Vogel RA, Corretti MC, Plotnick GD (1997) Effect of a single high-fat meal on endothelial function in healthy subjects. Am J Cardiol 79:350–354

    Article  CAS  PubMed  Google Scholar 

  • Wegner DM, Zanakos S (1994) Chronic thought suppression. J Pers 62:616–640

    Article  CAS  PubMed  Google Scholar 

  • Woodman RJ, Playford DA, Watts GF, Cheetham C, Reed C, Taylor RR, Puddey IB, Beilin LJ, Burke V, Mori TA, Green D (2001) Improved analysis of brachial artery ultrasound using a novel edge-detection software system. J Appl Physiol 91:929–937

    CAS  PubMed  Google Scholar 

  • Yeboah J, Folsom AR, Burke GL, Johnson C, Polak JF, Post W, Lima JA, Crouse JR, Herrington DM (2009) Predictive value of brachial flow-mediated dilation for incident cardiovascular events in a population-based study: the multi-ethnic study of atherosclerosis. Circulation 120:502–509

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This study was funded by a Natural Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant and Canada Foundation for Innovation and Ontario Ministry of Research and Innovation leaders Opportunities Funding to K.E. Pyke. T.J. King and V. Poitras were supported by NSERC PGS D scholarships.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen’s University, Kingston, ON, K7L 3N6, Canada

    T. J. King, H. Lemke, V. J. Poitras, B. J. Gurd & K. E. Pyke

  2. Department of Psychology, Queen’s University, Kingston, ON, Canada

    A. D. Green & D. A. Tripp

Authors
  1. T. J. King
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  2. H. Lemke
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  3. A. D. Green
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  4. D. A. Tripp
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  5. V. J. Poitras
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  6. B. J. Gurd
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  7. K. E. Pyke
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Correspondence to K. E. Pyke.

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Communicated by David C. Poole.

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King, T.J., Lemke, H., Green, A.D. et al. Impaired brachial artery endothelial function in young healthy women following an acute painful stimulus. Eur J Appl Physiol 115, 1547–1557 (2015). https://doi.org/10.1007/s00421-015-3139-3

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  • DOI: https://doi.org/10.1007/s00421-015-3139-3

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