American Journal of Cardiology
Volume 82, Issue 1 , Pages 1-6 , 1 July 1998

Heterogeneity among cardiac ischemic and anginal responses to exercise, mental stress, and daily life 1

  • DavidS Sheps, MD

      Affiliations

    • East Tennessee State University College of Medicine, Division of Cardiology, Johnson City, Tennessee, USA
    • Corresponding Author InformationAddress for correspondence: David S. Sheps, MD, MSPH, East Tennessee State University, Division of Cardiology, Box 70622, Johnson City, Tennessee 37614
    • ,
  • RobertP McMahon, PhD

      Affiliations

    • Maryland Medical Research Institute, Clinical Coordinating Center, Baltimore, Maryland, USA
    • ,
  • CarlJ Pepine, MD

      Affiliations

    • Cardiology, University of Florida, Gainesville, Florida, USA
    • ,
  • PeterH Stone, MD

      Affiliations

    • Cardiovascular Division, Brigham & Women′s Hospital, Boston, Massachusetts, USA
    • ,
  • A.David Goldberg, MD

      Affiliations

    • Henry Ford Hospital, Detroit, Michigan, USA
    • ,
  • Herman Taylor, MD

      Affiliations

    • Department of Medicine, University of Alabama, Birmingham, Alabama, USA
    • ,
  • JeromeD Cohen, MD

      Affiliations

    • St. Louis University Medical Center, St. Louis, Missouri, USA
    • ,
  • LewisC Becker, MD

      Affiliations

    • Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    • ,
  • Bernard Chaitman, MD

      Affiliations

    • St. Louis University Medical Center, St. Louis, Missouri, USA
    • ,
  • GennellL Knatterud, PhD

      Affiliations

    • Maryland Medical Research Institute, Clinical Coordinating Center, Baltimore, Maryland, USA
    • ,
  • PeterG Kaufmann, PhD

      Affiliations

    • Behavioral Medicine Research Group, National Heart, Lung and Blood Institute, Bethesda, Maryland, USA

Received 1 October 1997 ,Revised 17 February 1998 ,Accepted 17 February 1998.

References 

  1. Froelicher V. In: Manual of Exercise Testing. St. Louis, MO: CV Mosby; 1994;p. 90–109
  2. Trobaugh GB, Ritchie JL, Hamilton GW. Rest exercise imaging in coronary artery disease. In:  Ritchie JL,  Hamilton GW,  Frans Wackers JTh editor. Thallium-201 Myocardial Imaging. New York: Raven Press; 1978;p. 81–99
  3. Rozanski A, Bairy N, Krantz DS, Friedman J, Resser KJ, Morrell M, et al. Mental stress and the induction of silent myocardial ischaemia in patients with coronary artery disease. N Engl J Med. 1988;1005–1012
  4. Barry J, Selwyn AP, Nabel EG, Rocco MB, Mead K, Campbell S, et al. Frequency of ST-segment depression produced by mental stress in stable angina pectoris from coronary artery disease. Am J Cardiol. 1988;61:989–993
  5. LaVeau PJ, Rozanski A, Krantz DS, Cornell CE, Cattanach L, Zaret BL, et al. Transient left ventricular dysfunction during provocative mental stress in patients with coronary artery disease. Am Heart J. 1989;118:1–8
  6. Ironson G, Taylor CB, Boltwood M, Bartzokis T, Dennis C, Chesney M, et al. Effects of anger on left ventricular ejection fraction in coronary artery disease. Am J Cardiol. 1992;70:280–285
  7. Sheps DS, Ballenger MN, DeGent GE, Krittayaphong R, Dittman E, Maixner W, et al. Psychophysical responses to a speech stressor (correlation of plasma beta-endorphin levels at rest and after psychological stress with thermally measured pain threshold in patients with coronary artery disease). J Am Coll Cardiol. 1994;25:1499–1503
  8. Specchia G, de Servi S, Falcone C, Gavazzi A, Angoli L, Bramucci E, et al. Mental arithmetic stress testing in patients with coronary artery disease. Am Heart J. 1984;108:56–63
  9. Krantz DS, Helmers KF, Bairey CN, Nebel LE, Hedges SM, Rozanski A. Cardiovascular reactivity and mental stress-induced myocardial ischemia in patients with coronary artery disease. Psychosom Med. 1991;53:1–12
  10. Goldberg AD, Becker LC, Bonsall R, Cohen J, Ketterer MW, Krantz DS, Light KC, McMahon RP, Noreuil, Pepine CJ, Raczynski J, Sheps DS, Stone P, Strother D, Taylor H, for the PIMI Investigators. Psychophysiological investigations of myocardial ischemia: ischemic, hemodynamic, and neurohormone responses to mental and exercise stress. Circulation 1996;94:2402–2409
  11. Kaufmann P, McMahon RP, Becker LC, Bertolet B, Bonsall R, Chaitman B, et al. The phychophysiological investigations of myocardial ischemia (PIMI) study (objective, methods, variability of measures). Psychosom Med. 1998;60:56–62
  12. Tamesis B, Stelken A, Byers S, Shaw L, Younis L, Miller DD, et al. Comparison of the asymptomatic cardiac ischemia pilot and modified asymptomatic cardiac ischemia pilot versus bruce and cornell exercise protocols. Am J Cardiol. 1993;72:713–720
  13. Becker LC, Pepine CJ, Bonsall R, Cohen JD, Goldberg AD, Coghlan C, et al. Left ventricular, peripheral vascular and neurohumoral responses to Mental stress in normal middle aged men and women (reference group for the psychophysiologic investigations in myocardial ischemia (PIMI) study). Circulation. 1996;94:2768–2777
  14. Fleiss JL. In: Statistical Methods for Rates and Proportions. 2nd ed.. New York: John Wiley; 1981;p. 211–224
  15. SAS Insttitute Inc., SAS/STAT User′s Guide. Version 6. Fourth Edition, SAS Institute Inc., Cary, NC: 1989; vol 1:851–866; vol. 2:1351–1456.
  16. Rose GA. The diagnosis of ischemic heart pain and intermittent claudication in field surveys. Bull World Health Organ. 1962;27:645–658
  17. Greene AF, Schocken DD, Spielberger CD. Self-report of chest pain symptoms and coronary artery disease in patients undergoing angiography. Pain. 1991;47:319–324
  18. Sullivan M, Genter F, Savvides M, Roberts M, Myers J, Froelicher V. The reproducibility of hemodynamic electrocardiographic and gas exchange data during treadmill exercise in patients with angina pectoris. Chest. 1984;86:375–382
  19. Scardi S, Borgioni L, Cesanelli R, Pandullo C, Bovenzi M, Negro C. Evaluation of exercise test reproducibility in patients with ischemic cardiopathy. G Ital Cardiol. 1990;20:329–336
  20. Crea F, Margonato A, Kaski JC, Rodriguez-Plaza L, Meran DO, Davies G, et al. Variabilitiy of results during repeat exercise stress testing in patients with s angina pectoris (role of dynamic coronary flow reserve). Am Heart J. 1986;112:249–262
  21. Benhorin J, Pinsker G, Moriel M, Gavish A, Tzivoni D, Stern S. Ischemic threshold during two exercise testing protocols and during ambulatory electrocardiographic monitoring. J Am Coll Cardiol. 1993;22:671–677
  22. Froelicher VF. In: Exercise and the Heart. St. Louis, MO: CV Mosby; 1993;p. 121
  23. Hambrecht R, Schuler GC, Muth T, Grunze MF, Marburger CT, Niebauer J, et al. Greater diagnostic sensitivity of treadmill versus cycle exercise testing of asymptomatic men with coronary artery disease. Am J Cardiol. 1992;70:141–146
  24. Bairey CN, Rozanski A, Levey M, Berman DS. Differences in the frequency of STsegment depression during upright and supine exercise (assessment in normals and in patients with coronary artery disease). Am Heart J. 1997;1317–1323

☆ The Psychophysiologic Interventions of Myocardial Ischemia (PIMI) was supported by contracts HV 18114, HV 18119-HV 18121, and HV 28127 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland. Support for ECG data collection was provided in part by Applied Cardiac Systems, Laguna Hills, California; Mortara Instrument Corporation, Milwaukee, Wisconsin; Marquette Electronics, and Quinton Instruments, Seattle, Washington. Support for blood pressure data collection was provided in part by Critikon, Tampa, Florida.

PII: S0002-9149(98)00228-8

American Journal of Cardiology
Volume 82, Issue 1 , Pages 1-6 , 1 July 1998

Article Tools