Anxiety and hemodynamic reactivity during cardiac stress testing: The role of gender and age in myocardial ischemia

Bekendam, Maria; Mommersteeg, Paula M.C.; Kop, Willem J.; Widdershoven, Jos; Vermeltfoort, Ilse A C

doi:10.1007/s12350-020-02079-3

Cited by 12 publications

(9 citation statements)

References 53 publications

(59 reference statements)

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“…The association between acute emotions and ischemia during MPI is likely [20][21][22][23][24][25] , but evidence to date is based on self-reported emotions only. The unique aspect of this study is the measurement of acute emotions using facial expression recognition software during cardiac stress testing as part of MPI 26 . It is unknown whether acute negative emotions measured during cardiac stress testing are associated with the presence or absence of anginal complaints reported during cardiac stress testing in patients with (suspect) CMD.…”

Section: Introductionmentioning

confidence: 99%

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

Bekendam

Vermeltfoort

Kop

et al. 2022

Journal of Nuclear Cardiology

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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.

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Section: Introductionmentioning

confidence: 99%

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

Bekendam

Vermeltfoort

Kop

et al. 2022

Journal of Nuclear Cardiology

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“…To reduce bias related to multicollinearity, the joint effects of emotional states and psychological background factors were examined for each psychological background factor separately. We also explored potential interaction terms with sex, consistent with our prior report based on this study (33), and examined interactions between the facial emotion expression measures and each of the psychological background factors as related to myocardial ischemia, to examine potential synergy between these two domains of assessment. ORs with 95% confidence intervals (CIs) are reported for logistic regression analyses.…”

Section: Statistical Analysesmentioning

confidence: 98%

Facial Emotion Expression and the Inducibility of Myocardial Ischemia During Cardiac Stress Testing: The Role of Psychological Background Factors

et al. 2022

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ObjectiveNegative emotional states, such as anger and anxiety, are associated with the onset of myocardial infarction and other acute clinical manifestations of ischemic heart disease. The likelihood of experiencing these short-term negative emotions has been associated with long-term psychological background factors such as depression, generalized anxiety, and personality factors. We examined the association of acute emotional states preceding cardiac stress testing (CST) with inducibility of myocardial ischemia and to what extent psychological background factors account for this association.MethodsEmotional states were assessed in patients undergoing CST (n = 210; mean [standard deviation] age = 66.9 [8.2] years); 91 (43%) women) using self-report measures and video recordings of facial emotion expression. Video recordings were analyzed for expressed anxiety, anger, sadness, and happiness before CST. Psychological background factors were assessed with validated questionnaires. Single-photon emission computed tomography was used to evaluate inducibility of ischemia.ResultsIschemia occurred in 72 patients (34%). Emotional states were not associated with subsequent inducibility of ischemia during CST (odds ratio between 0.93 and 1.04; p values > .50). Psychological background factors were also not associated with ischemia (odds ratio between 0.96 and 1.06 per scale unit; p values > .20) and did not account for the associations of emotional states with ischemia.ConclusionsEmotional states immediately before CST and psychological background factors were not associated with the inducibility of ischemia. These findings indicate that the well-documented association between negative emotions with acute clinical manifestations of ischemic heart disease requires a different explanation than a reduced threshold for inducible ischemia.

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“…[8]. If we consider differences associated with gender, studies consistently show that females have more anxiety [9]. Pre-pandemic factors also should be considered; the literature has shown that patients commonly experience stress when undergoing dental treatment.…”

Section: Introductionmentioning

confidence: 99%

Anxiety and facial self-contacts: possible impact on COVID-19 transmission in dental practice

et al. 2021

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Background The purpose was to analyse the associations between dental and trait anxiety, fear of COVID-19 and the duration and frequency of spontaneous hand-to-face contact (self-contact). Methods A cross-sectional design was carried out with 128 adult patients from four dental clinics in Madrid, during the confinement, from March 15 to May 15. The patients’ movements in the waiting room were monitored with Microsoft Kinect Software, also completed the Trait anxiety subscale of the STAI, the COVID-19 Fear and the S-DAI questionnaire. Results Associations were observed between the duration and frequency of facial, mask and eye contact with trait anxiety and dental fear was determined only by the frequency of this self-contact. Trait anxiety is associated with dental anxiety and with fear of COVID-19. Although facial self-contact is higher in women, it also rises in men as dental fear increases. Moreover, dental anxiety is a good predictor of trait anxiety and the incidence of facial self-contact. Conclusions Understanding the possible associations between biopsychosocial factors, such as trait anxiety, dental anxiety and self-contact is important. It may help to prevent the spread of COVID-19 in the population as well as enabling the formulation of effective interventions to improve oral health care through the implementation of dental care programmes.

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Anxiety and hemodynamic reactivity during cardiac stress testing: The role of gender and age in myocardial ischemia

Cited by 12 publications

References 53 publications

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

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

Facial Emotion Expression and the Inducibility of Myocardial Ischemia During Cardiac Stress Testing: The Role of Psychological Background Factors

Anxiety and facial self-contacts: possible impact on COVID-19 transmission in dental practice

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