A meta-analysis on the prevalence, associated factors and diagnostic methods of mental stress induced myocardial ischemia

Zhang, Lijun; Bao, Yanping; Wang, Xi; Zhou, Yi; Tao, Shuhui; Xu, Wan

doi:10.1186/s12967-020-02383-z

Cited by 16 publications

(12 citation statements)

References 45 publications

(48 reference statements)

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“…Exposure to stress contributes to a broad range of health problems, likely mediated by the immunosuppressive effects triggered by stress. Similarly, stress-related negative affect can relate to health problems, such as cardiovascular impairment, diabetes, and slow recovery from cancer (Everson-Rose & Lewis, 2005; Smith et al, 2004; Zhang et al, 2020). In addition, there is increasing evidence that positive affect relates negatively to health problems, even when controlling for negative affect (Chida & Steptoe, 2008; Kushlev et al, 2020; Pressman et al, 2019).…”

Section: Studymentioning

confidence: 99%

A three-dimensional taxonomy of achievement emotions.

Pekrun¹,

Marsh²,

Elliot³

et al. 2023

Journal of Personality and Social Psychology

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We present a three-dimensional taxonomy of achievement emotions that considers valence, arousal, and object focus as core features of these emotions. By distinguishing between positive and negative emotions (valence), activating and deactivating emotions (arousal), and activity emotions, prospective outcome emotions, and retrospective outcome emotions (object focus), the taxonomy has a 2 × 2 × 3 structure representing 12 groups of achievement emotions. In four studies across different countries (N = 330, 235, 323, and 269 participants in Canada, the United States, Germany, and the U.K., respectively), we investigated the empirical robustness of the taxonomy in educational (Studies 1–3) and work settings (Study 4). An expanded version of the Achievement Emotions Questionnaire was used to assess 12 key emotions representing the taxonomy. Consistently across the four studies, findings from multilevel facet analysis and structural equation modeling documented the importance of the three dimensions for explaining achievement emotions. In addition, based on hypotheses about relations with external variables, the findings show clear links of the emotions with important antecedents and outcomes. The Big Five personality traits, appraisals of control and value, and context perceptions were predictors of the emotions. The 12 emotions, in turn, were related to participants’ use of strategies, cognitive performance, and self-reported health problems. Taken together, the findings provide robust evidence for the unique positions of different achievement emotions in the proposed taxonomy, as well as unique patterns of relations with external variables. Directions for future research and implications for policy and practice are discussed.

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Section: Studymentioning

confidence: 99%

A three-dimensional taxonomy of achievement emotions.

Pekrun¹,

Marsh²,

Elliot³

et al. 2023

Journal of Personality and Social Psychology

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“…In the general population, free of clinically evident CAD, the hazard ratios of coronary and cerebrovascular events attributable to stress are lower compared with classic risk factors [ 31 , 32 , 33 ]. The prevalence of MSIMI in patients with stable CAD varies widely, between 20% and 70%, as the result of differences in the type of mental stress used, diagnostic methods employed, and psychological profile [ 34 ]. In patients with CAD, the presence of MSIMI is associated with a two-fold increase in the incidence of adverse cardiac events, independent of physical or pharmacological stress-induced ischemia, even after adjusting for established risk factors, such as diabetes, obesity, and sedentary life [ 35 , 36 , 37 ].…”

Section: Mental Stress-induced Myocardial Ischemia (Msimi)mentioning

confidence: 99%

“…Moreover, incorporating psychosocial risk factors into the Framingham risk score improves the prediction of CAD [ 38 ]. In up to 50% of patients with stable CAD, ischemic responses are triggered not only by extremely severe emotional stress, but also by environmental challenges that may be encountered in everyday life [ 26 , 34 , 39 ]. In these patients, MSIMI occurs more frequently than exercise-induced myocardial ischemia and may also be present in those with no signs of myocardial ischemia during exercise.…”

Section: Mental Stress-induced Myocardial Ischemia (Msimi)mentioning

confidence: 99%

Mental Stress and Cardiovascular Health—Part I

Vancheri¹,

Longo²,

Vancheri

et al. 2022

JCM

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Epidemiological studies have shown that a substantial proportion of acute coronary events occur in individuals who lack the traditional high-risk cardiovascular (CV) profile. Mental stress is an emerging risk and prognostic factor for coronary artery disease and stroke, independently of conventional risk factors. It is associated with an increased rate of CV events. Acute mental stress may develop as a result of anger, fear, or job strain, as well as consequence of earthquakes or hurricanes. Chronic stress may develop as a result of long-term or repetitive stress exposure, such as job-related stress, low socioeconomic status, financial problems, depression, and type A and type D personality. While the response to acute mental stress may result in acute coronary events, the relationship of chronic stress with increased risk of coronary artery disease (CAD) is mainly due to acceleration of atherosclerosis. Emotionally stressful stimuli are processed by a network of cortical and subcortical brain regions, including the prefrontal cortex, insula, amygdala, hypothalamus, and hippocampus. This system is involved in the interpretation of relevance of environmental stimuli, according to individual’s memory, past experience, and current context. The brain transduces the cognitive process of emotional stimuli into hemodynamic, neuroendocrine, and immune changes, called fight or flight response, through the autonomic nervous system and the hypothalamic–pituitary–adrenal axis. These changes may induce transient myocardial ischemia, defined as mental stress-induced myocardial ischemia (MSIMI) in patients with and without significant coronary obstruction. The clinical consequences may be angina, myocardial infarction, arrhythmias, and left ventricular dysfunction. Although MSIMI is associated with a substantial increase in CV mortality, it is usually underestimated because it arises without pain in most cases. MSIMI occurs at lower levels of cardiac work than exercise-induced ischemia, suggesting that the impairment of myocardial blood flow is mainly due to paradoxical coronary vasoconstriction and microvascular dysfunction.

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mentioning

confidence: 99%

“…In this context, sufficient evidence now suggests that mental stress can trigger myocardial infarction, reversible cardiomyopathy, and sudden cardiac death in susceptible individuals . The link between mental stress and CHD was first described over a century ago and has become an important topic of research over the past 40 years . In a meta-analysis of 20 studies involving 3164 individuals with CHD, mental stress provoked in a controlled environment (eg, public speaking, mental arithmetic, anger recall) was associated with inducing myocardial ischemia in 32% of patients with CHD in the form of either transient regional wall motion abnormalities on echocardiography, ST-segment deviation on electrocardiography, or reversible defects on myocardial perfusion imaging with single-photon emission computed tomography (SPECT) .…”

mentioning

confidence: 99%