Some patients with coronary artery disease have sufficient blood flow to the heart muscle during periods of emotional / emotional stress. This condition, called "cardiac induced ischemia" (MSIMI), is related to the severity of coronary buildup in men, but not in women, Psychosomatic Medicine: Journal of Biobehavioral Medicine, The official journal of the American Psychosomatic Society. The journal is published in the Lipinkot case by Walters Kloer.
Ischemia Myocardial infarction is caused in both men and women, although younger women tend to have more than this phenomenon. While MSIMI is associated with poorer cardiovascular outcomes in both sexes, there may be gender differences in the mechanism by which stress can cause MSIMI, according to a new study by Viola Vaccarino, MD, PhD and colleagues at Emory University School of Public Health, .
A cardiac response to stress related to the severity of coronary artery disease in men, but not in women
The researchers looked at the specific relationship between coronary heart disease (angiogram) and angiogram, measured in angiogram and MSIMI in 276 subjects – 141 men and 135 women – with new myocardial infarction (heart attack). The study focused on young and young adults (under the age of 61). All participants underwent conventional stress tests to assess blood flow and cardiac muscle in response to a physical or pharmacological challenge (or exercise stress test or pharmacological test).
Patients also underwent a stress test, which assessed blood flow in the heart muscle in response to a stressful situation (speech assignment). Based on reduced blood flow in the myocardium during this stressful challenge, 17% of the patients were classified as having MSIMI.
Women had a higher rate of MSIMI (20 percent) than men (15 percent). Twenty-seven percent of patients had myocardial ischemia (CSIMI). Only 10% of patients had both MSIMI and CSIMI.
In both men and women, the presence of CSIMI has been associated with the severity of coronary heart disease. For each unit increase in severity score, the probability of CSIMI increased by about 50 percent, after adjustment for other factors.
In contrast, the presence of MSIMI was associated with stronger plaque growth only in men: for each increase of one unit in the severity classification, MSIMI was nearly doubled. In women, MSIMI was not associated with the severity of the disease.
"There is growing evidence that psychosocial pressure may promote the development and development of cardiovascular disease in susceptible individuals," the researchers said. However, the association between MSIMI and obstructive kidney disease, ie blockages in the major coronary arteries that provide blood to the myocardium, was unclear. Women tend more than men to develop cardiac ischemia without coronary blockage.
The results support the hypothesis that MSIMI may develop through different mechanisms in women than men. According to previous findings on gender differences in heart disease, MSIMI in women may reflect abnormalities other than obstruction of the coronary arteries, such as a malfunction of the smaller coronary arteries (colon dysfunction).
Gender differences may have important implications for understanding the particular vascular effects of the psychological strain in general and the mechanisms of MSIMI in particular, since most previous studies on this subject have focused on men. "These results suggest that MSIMI must be driven by alternative mechanisms especially for women, and provide motivation for further research to understand gender-specific mechanisms on the effects of mental stress on cardiac ischemia and long-term outcomes," the authors conclude.
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