PMID- 28986223
OWN - NLM
STAT- MEDLINE
DCOM- 20190312
LR  - 20190424
IS  - 1090-2139 (Electronic)
IS  - 0889-1591 (Print)
IS  - 0889-1591 (Linking)
VI  - 68
DP  - 2018 Feb
TI  - Inflammatory response to mental stress and mental stress induced myocardial 
      ischemia.
PG  - 90-97
LID - S0889-1591(17)30457-9 [pii]
LID - 10.1016/j.bbi.2017.10.004 [doi]
AB  - BACKGROUND: Mental stress-induced myocardial ischemia (MSIMI) is associated with 
      increased risk of adverse cardiovascular outcomes, yet the underlying mechanisms 
      are not well understood. We measured the inflammatory response to acute 
      laboratory mental stress in patients with coronary artery disease (CAD) and its 
      association with MSIMI. We hypothesized that patients with MSIMI would have a 
      higher inflammatory response to mental stress in comparison to those without 
      ischemia. METHODS: Patients with stable CAD underwent 99mTc sestamibi myocardial 
      perfusion imaging during mental stress testing using a public speaking stressor. 
      MSIMI was determined as impaired myocardial perfusion using a 17-segment model. 
      Inflammatory markers including interleukin-6 (IL-6), monocyte chemoattractant 
      protein-1 (MCP-1), matrix metallopeptidase 9 (MMP-9) and high-sensitivity C 
      reactive protein (hsCRP) were measured at rest and 90 min after mental stress. 
      Results were validated in an independent sample of 228 post-myocardial infarction 
      patients. RESULTS: Of 607 patients analyzed in this study, (mean age 
      63 +/- 9 years, 76% male), 99 (16.3%) developed MSIMI. Mental stress resulted in a 
      significant increase in IL-6, MCP-1, and MMP-9 (all p <0.0001), but not hsCRP. 
      However, the changes in these markers were similar in those with and without 
      MSIMI. Neither resting levels of these biomarkers, nor their changes with mental 
      stress were significantly associated with MSIMI. Results in the replication 
      sample were similar. CONCLUSION: Mental stress is associated with acute increases 
      in several inflammatory markers. However, neither the baseline inflammatory 
      status nor the magnitude of the inflammatory response to mental stress over 
      90 min were significantly associated with MSIMI.
CI  - Copyright (c) 2017. Published by Elsevier Inc.
FAU - Hammadah, Muhammad
AU  - Hammadah M
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Sullivan, Samaah
AU  - Sullivan S
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Pearce, Brad
AU  - Pearce B
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Al Mheid, Ibhar
AU  - Al Mheid I
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Wilmot, Kobina
AU  - Wilmot K
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Ramadan, Ronnie
AU  - Ramadan R
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Tahhan, Ayman Samman
AU  - Tahhan AS
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - O'Neal, Wesley T
AU  - O'Neal WT
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Obideen, Malik
AU  - Obideen M
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Alkhoder, Ayman
AU  - Alkhoder A
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Abdelhadi, Naser
AU  - Abdelhadi N
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Mohamed Kelli, Heval
AU  - Mohamed Kelli H
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Ghafeer, Mohamad Mazen
AU  - Ghafeer MM
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Pimple, Pratik
AU  - Pimple P
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Sandesara, Pratik
AU  - Sandesara P
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Shah, Amit J
AU  - Shah AJ
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States; Department of Epidemiology, Rollins School 
      of Public Health, Emory University, Atlanta, GA, United States; Atlanta VA 
      Medical Center, Decatur, GA, United States.
FAU - Hosny, Kareem Mohammed
AU  - Hosny KM
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Ward, Laura
AU  - Ward L
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Ko, Yi-An
AU  - Ko YA
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Sun, Yan V
AU  - Sun YV
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Weng, Lei
AU  - Weng L
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Kutner, Michael
AU  - Kutner M
AD  - Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 
      Emory University, Atlanta, GA, United States.
FAU - Bremner, J Douglas
AU  - Bremner JD
AD  - Atlanta VA Medical Center, Decatur, GA, United States; Department of Psychiatry 
      and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United 
      States.
FAU - Sheps, David S
AU  - Sheps DS
AD  - University of Florida Health Science Center, Department of Medicine, Division of 
      Cardiovascular Medicine, Gainesville, FL, United States.
FAU - Esteves, Fabio
AU  - Esteves F
AD  - Department of Radiology, Emory University School of Medicine, Atlanta, GA, United 
      States.
FAU - Raggi, Paolo
AU  - Raggi P
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States; Department of Radiology, Emory University School of 
      Medicine, Atlanta, GA, United States; Mazankowski Alberta Heart Institute, 
      University of Alberta, Edmonton, Alberta, Canada.
FAU - Vaccarino, Viola
AU  - Vaccarino V
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States; Department of Epidemiology, Rollins School 
      of Public Health, Emory University, Atlanta, GA, United States. Electronic 
      address: lvaccar@emory.edu.
FAU - Quyyumi, Arshed A
AU  - Quyyumi AA
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States. Electronic address: aquyyum@emory.edu.
LA  - eng
GR  - R56 HL126558/HL/NHLBI NIH HHS/United States
GR  - KL2 TR000455/TR/NCATS NIH HHS/United States
GR  - R01 HL109413/HL/NHLBI NIH HHS/United States
GR  - K24 HL077506/HL/NHLBI NIH HHS/United States
GR  - R01 HL125246/HL/NHLBI NIH HHS/United States
GR  - F32 HL134290/HL/NHLBI NIH HHS/United States
GR  - T32 HL130025/HL/NHLBI NIH HHS/United States
GR  - P01 HL086773/HL/NHLBI NIH HHS/United States
GR  - UL1 TR000454/TR/NCATS NIH HHS/United States
GR  - UL1 TR002378/TR/NCATS NIH HHS/United States
GR  - K24 MH076955/MH/NIMH NIH HHS/United States
GR  - P20 HL113451/HL/NHLBI NIH HHS/United States
GR  - P01 HL101398/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20171003
PL  - Netherlands
TA  - Brain Behav Immun
JT  - Brain, behavior, and immunity
JID - 8800478
RN  - 0 (CCL2 protein, human)
RN  - 0 (Chemokine CCL2)
RN  - 0 (Interleukin-6)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - EC 3.4.24.35 (Matrix Metalloproteinase 9)
SB  - IM
MH  - Aged
MH  - C-Reactive Protein
MH  - Chemokine CCL2
MH  - Coronary Artery Disease/physiopathology
MH  - Female
MH  - Humans
MH  - Inflammation/metabolism
MH  - Interleukin-6
MH  - Male
MH  - Matrix Metalloproteinase 9
MH  - Middle Aged
MH  - Myocardial Ischemia/*physiopathology
MH  - Myocardial Perfusion Imaging/methods
MH  - Stress, Psychological/*immunology/metabolism/*physiopathology
PMC - PMC5808921
MID - NIHMS940282
OTO - NOTNLM
OT  - C reactive protein
OT  - Inflammation
OT  - Interleukin 6
OT  - Matrix metallopeptidase 9
OT  - Mental stress
OT  - Monocyte chemoattractant protein-1
OT  - Myocardial ischemia
COIS- Conflicts of interest None of the other authors report conflict of interest 
      relevant to this article.
EDAT- 2017/10/08 06:00
MHDA- 2019/03/13 06:00
PMCR- 2019/02/01
CRDT- 2017/10/08 06:00
PHST- 2017/07/15 00:00 [received]
PHST- 2017/09/17 00:00 [revised]
PHST- 2017/10/02 00:00 [accepted]
PHST- 2017/10/08 06:00 [pubmed]
PHST- 2019/03/13 06:00 [medline]
PHST- 2017/10/08 06:00 [entrez]
PHST- 2019/02/01 00:00 [pmc-release]
AID - S0889-1591(17)30457-9 [pii]
AID - 10.1016/j.bbi.2017.10.004 [doi]
PST - ppublish
SO  - Brain Behav Immun. 2018 Feb;68:90-97. doi: 10.1016/j.bbi.2017.10.004. Epub 2017 
      Oct 3.