Psychological factors of suspect coronary microvascular dysfunction in patients undergoing SPECT imaging

Abstract

Background Patients with myocardial ischemia in the absence of obstructive coronary artery disease (CAD) often experience anginal complaints and are at risk of cardiac events. Stress-related psychological factors and acute negative emotions might play a role in these patients with suspect coronary microvascular dysfunction (CMD). Methods and Results 295 Patients (66.9 ± 8.7 years, 46% women) undergoing myocardial perfusion single-photon-emission computed tomography (MPI-SPECT), were divided as follows: (1) a non-ischemic reference group (n = 136); (2) patients without inducible ischemia, but with a history of CAD (n = 62); (3) ischemia and documented CAD (n = 52); and (4) ischemia and suspect CMD (n = 45). These four groups were compared with regard to psychological factors and acute emotions. Results revealed no differences between the groups in psychological factors (all P > .646, all effect sizes d < .015). State sadness was higher for patients with suspect CMD (16%) versus the other groups (P = .029). The groups did not differ in the association of psychological factors or emotions with anginal complaints (all P values > .448). Conclusion Suspect CMD was not associated with more negative psychological factors compared to other groups. State sadness was significantly higher for patients with suspect CMD, whereas no differences in state anxiety and other psychological factors were found.

Clinical and psychological characteristics of patients with ischemia and non-obstructive coronary arteries (INOCA) and obstructive coronary artery disease

“…It is unclear how psychological distress differs between patients with INOCA and patients with obstructive coronary artery disease (CAD). Both higher and similar levels of psychological distress in INOCA patients compared to obstructive CAD and non-cardiac patients have been found [12] , [13] , [14] , [15] . The present study aims to further contribute to the controversy about psychological distress occurrences in INOCA patients.…”

“…The THIO study includes patients with cardiac complaints referred for a myocardial perfusion imaging single-photon emission computed tomography (MPI-SPECT; cardiac stress testing). The study has been described in more detail elsewhere [15] .…”

“…Myocardial ischemia was detected semi-quantitatively by the nuclear physician using a summed difference score ≥ 2 as well as visual analysis, as was recommended by the American Society of Nuclear Cardiology [15] . Electronic medical records of CAG or computed tomography (CTCA) were examined for significant obstructions of the coronary arteries within a time frame of six months before or after the myocardial perfusion imaging.…”

Predicción de lesiones coronarias significativas mediante perfusión miocárdica con SPECT. Resultados de un centro de referencia nacional en Lima-Perú

“…La disfunción coronaria microvascular no es condición benigna como se pensaba anteriormente. Se ha demostrado que esta patología incrementa el riesgo cardiovascular, altera la calidad de vida y se relaciona con hospitalizaciones frecuentes y con mayores eventos cardiovasculares 16 , 17 .…”

The Role of Mental Stress in Ischaemia with No Obstructive Coronary Artery Disease and Coronary Vasomotor Disorders

“…29,[32][33][34][35][36][37] However, only a few studies have looked specifically at INOCA patients. [38][39][40][41][42] This review will provide an overview of the research on the effect of psychosocial stress in patients with INOCA and/or coronary vasomotor disorders. Furthermore, sex differences in pathophysiology will be described, as the impact of psychological stress is different between women and men.…”