PMID- 33037938
OWN - NLM
STAT- MEDLINE
DCOM- 20210423
LR  - 20210423
IS  - 1534-3170 (Electronic)
IS  - 1523-3782 (Linking)
VI  - 22
IP  - 12
DP  - 2020 Oct 10
TI  - The Foundational Role of Cardiovascular Imaging in the Characterization of Mental 
      Stress-Induced Myocardial Ischemia in Patients with Coronary Artery Disease.
PG  - 162
LID - 10.1007/s11886-020-01407-w [doi]
AB  - PURPOSE OF REVIEW: Mental stress-provoked myocardial ischemia (MSIMI) is an 
      ischemic phenomenon provoked by the experience of psychologically stressful 
      circumstances. While MSIMI was initially identified 50 years ago during 
      activities of daily living through the use of wearable Holter monitor, subsequent 
      research utilized the technologies of cardiac imaging-ventriculography and 
      myocardial perfusion-under controlled conditions to pursue an understanding of 
      pathophysiology and prognosis. This work revealed that MSIMI occurs in almost 
      half of patients with stable coronary artery disease (CAD) and is associated with 
      cardiac events and early mortality. We provide a focused review of the 
      instrumental role that cardiac imaging has played in elucidating how stress 
      affects cardiac physiology and how emerging diagnostic techniques will allow for 
      further research on stress-mediated changes in the coronary macro- and 
      microvasculature. RECENT FINDINGS: Observations about the cardiac response to 
      mental stress diverge from underlying cornerstones of the traditional CAD 
      paradigm which is based upon myocardial oxygen demand and the degree of 
      epicardial coronary stenosis. Evidence from studies utilizing non-invasive and 
      invasive studies of coronary perfusion indicates perturbations in the 
      microvascular compartment in response to mental stress. Cardiovascular imaging 
      enjoined with mental stress provocation may be a commanding tool to advance our 
      understanding of non-obstructive CAD and the coronary microvasculature. This 
      further understanding will facilitate incorporation of mental stress testing in 
      the clinical care of patients with discrepant diagnostic work-up of CAD and in 
      patients who experience anginal symptoms due to non-exertional and/or emotional 
      triggers. Such algorithms will be crucial to identify treatment targets to modify 
      the risk associated with mental stress-associated ischemia and adverse prognosis.
FAU - Meadows, Judith L
AU  - Meadows JL
AUID- ORCID: 0000-0002-1820-2933
AD  - Section of Cardiovascular Medicine, Yale School of Medicine, 950 Campbell Ave. / 
      111B, West Haven, CT, 06516, USA.
AD  - VA Connecticut Healthcare System, West Haven, CT, USA.
FAU - Shah, Samit
AU  - Shah S
AUID- ORCID: 0000-0002-3664-4102
AD  - Section of Cardiovascular Medicine, Yale School of Medicine, 950 Campbell Ave. / 
      111B, West Haven, CT, 06516, USA.
AD  - VA Connecticut Healthcare System, West Haven, CT, USA.
FAU - Burg, Matthew M
AU  - Burg MM
AUID- ORCID: 0000-0002-1263-2385
AD  - Section of Cardiovascular Medicine, Yale School of Medicine, 950 Campbell Ave. / 
      111B, West Haven, CT, 06516, USA.
AD  - VA Connecticut Healthcare System, West Haven, CT, USA.
FAU - Pfau, Steven
AU  - Pfau S
AUID- ORCID: 0000-0002-9225-0693
AD  - Section of Cardiovascular Medicine, Yale School of Medicine, 950 Campbell Ave. / 
      111B, West Haven, CT, 06516, USA.
AD  - VA Connecticut Healthcare System, West Haven, CT, USA.
FAU - Soufer, Robert
AU  - Soufer R
AUID- ORCID: 0000-0001-5664-1438
AD  - Section of Cardiovascular Medicine, Yale School of Medicine, 950 Campbell Ave. / 
      111B, West Haven, CT, 06516, USA. robert.soufer@yale.edu.
AD  - VA Connecticut Healthcare System, West Haven, CT, USA. robert.soufer@yale.edu.
LA  - eng
GR  - R01HL 59619/HL/NHLBI NIH HHS/United States
GR  - R01HL126770/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Review
DEP - 20201010
PL  - United States
TA  - Curr Cardiol Rep
JT  - Current cardiology reports
JID - 100888969
SB  - IM
MH  - Activities of Daily Living
MH  - *Coronary Artery Disease/diagnostic imaging
MH  - Exercise Test
MH  - Humans
MH  - *Myocardial Ischemia/diagnostic imaging
MH  - *Myocardial Perfusion Imaging
OTO - NOTNLM
OT  - Coronary artery disease
OT  - Mental stress-provoked ischemia
OT  - Microvascular disease
EDAT- 2020/10/11 06:00
MHDA- 2021/04/24 06:00
CRDT- 2020/10/10 12:04
PHST- 2020/09/01 00:00 [accepted]
PHST- 2020/10/10 12:04 [entrez]
PHST- 2020/10/11 06:00 [pubmed]
PHST- 2021/04/24 06:00 [medline]
AID - 10.1007/s11886-020-01407-w [pii]
AID - 10.1007/s11886-020-01407-w [doi]
PST - epublish
SO  - Curr Cardiol Rep. 2020 Oct 10;22(12):162. doi: 10.1007/s11886-020-01407-w.