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Pathophysiological processes underlying emotional triggering of acute cardiac events

Strike, PC; Magid, K; Whitehead, DL; Brydon, L; Bhattachatyya, MR; Steptoe, A; (2006) Pathophysiological processes underlying emotional triggering of acute cardiac events. P NATL ACAD SCI USA , 103 (11) 4322 - 4327. 10.1073/pnas.0507097103. Gold open access

Abstract

Acute negative emotional states may act as triggers of acute coronary syndrome (ACS), but the biological mechanisms involved are not known. Heightened platelet activation and hemodynamic shear stress provoked by acute stress may contribute. Here we investigated whether patients whose ACS had been preceded by acute anger, stress, or depression would show heightened hemodynamic and platelet activation in response to psychophysiological stress testing. We studied 34 male patients an average of 15 months after they had survived a documented ACS. According to an interview conducted within 5 days of hospital admission, 14 men had experienced acute negative emotion in the 2 h before symptom onset, and 20 men had not experienced any negative emotion. Hemodynamic variables and platelet activation were monitored during performance of challenging color-word interference and public speaking tasks and over a 2-h poststress recovery period. The emotion trigger group showed significantly greater increases in monocyte-platelet, leukocyte-platelet, and neutrophil-platelet aggregate responses to stress than the nontrigger group, after adjusting for age, body mass, smoking status, and medication. Monocyte-platelet aggregates remained elevated for 30 min after stress in the emotion trigger group. The emotion trigger group also showed poststress delayed recovery of systolic pressure and cardiac output compared with the nontrigger group. These results suggest that some patients with coronary artery disease may be particularly susceptible to emotional triggering of ACS because of heightened platelet activation in response to psychological stress, coupled with impaired hemodynamic poststress recovery.

Type: Article
Title: Pathophysiological processes underlying emotional triggering of acute cardiac events
Open access status: An open access publication
DOI: 10.1073/pnas.0507097103
Publisher version: http://www.ncbi.nlm.nih.gov/pmc/ articles/PMC14496...
Keywords: acute coronary syndrome, blood pressure, platelets, stress, myocardial infarction, CORONARY-ARTERY-DISEASE, ACUTE MYOCARDIAL-INFARCTION, EPIDEMIOLOGY PROGRAM SHEEP, MENTAL STRESS, PSYCHOPHYSIOLOGICAL INVESTIGATIONS, PSYCHOLOGICAL STRESS, SOCIOECONOMIC-STATUS, PLATELET ACTIVATION, RISK-FACTORS, P-SELECTIN
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: http://discovery.ucl.ac.uk/id/eprint/6640
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