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Mental stress-induced myocardial ischemia in women with angina and normal coronary angiograms

  • Original Articles
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Coronary artery disease is frequent in postmenopausal women. Silent myocardial ischemia has been induced with mental stress testing.

Methods and Results

To evaluate whether mental stress can induce ischemia in women with typical angina and normal coronary angiography, postmenopausal patients (n = 16) were studied. Each underwent technetium 99m methoxyisobutylisonitrile myocardial scintigraphy (exercise stress/rest/mental stress protocol), brachial artery endothelial function measurement by ultrasonography, and 24-hour ambulatory electrocardiographic recording (Holter). During mental stress testing, 6 patients (group I) had reversible perfusion defects on myocardial scintigraphy whereas the other 10 patients (group II) did not. Group I patients exhibited endothelial dysfunction more frequently than those in group II (83% vs 20%). Myocardial scintigraphy showed anteroapical/septal ischemia in 5 patients and inferoapical ischemia in one other patient, with both types of stress. Among group II patients, none showed a reversible perfusion defect during physical or mental stress. No group I patients had evidence of ischemia by Holter monitoring, whereas 2 of 10 group II patients did.

Conclusion

In postmenopausal women with typical angina and normal coronary arteries, mental stress may provoke myocardial ischemia, which can be concordant with ischemia induced by exercise stress, and is associated with endothelial dysfunction.

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Authors and Affiliations

  1. Nuclear Medicine Department, Institute of Cardiology, 17 No. 702, Vedado, CP 10400, La Habana, Cuba

    Amalia Peix, Felizardo Ponce, Juan Valiente, Francisco Tornés, Lázaro O. Cabrera, Israel Guerrero, Ernesto J. García, Regla Carrillo & David García-Barreto

  2. Psychology Department, Policlinic Plaza, La Habana, Cuba

    Angelina Trápaga, Lucrecia Asen & Olga Infante

Authors
  1. Amalia Peix
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  2. Felizardo Ponce
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  3. Juan Valiente
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  5. Lázaro O. Cabrera
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  6. Israel Guerrero
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  7. Ernesto J. García
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  8. Regla Carrillo
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  9. David García-Barreto
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  10. Angelina Trápaga
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  12. Olga Infante
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Correspondence to Amalia Peix.

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Peix, A., Ponce, F., Valiente, J. et al. Mental stress-induced myocardial ischemia in women with angina and normal coronary angiograms. J Nucl Cardiol 13, 507–513 (2006). https://doi.org/10.1016/j.nuclcard.2006.03.016

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  • DOI: https://doi.org/10.1016/j.nuclcard.2006.03.016

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