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Repolarization changes induced by mental stress in normal subjects and patients with coronary artery disease: effect

Peter Taggart1, Velislav N Batchvarov, Peter Sutton

  • 1Department of Cardiology, The Hatter Institute and Centre for Cardiology, University College London Hospitals, London, UK. peter.taggart@uclh.org

Psychosomatic Medicine
|January 7, 2009
PubMed

Insights

Mental stress impacts ventricular repolarization differently in coronary artery disease (CAD) patients versus healthy individuals. Nitroglycerine (NTG) significantly reduces these stress-induced repolarization differences in CAD patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Psychocardiology

Background:

  • Mental stress can alter cardiac repolarization, potentially leading to arrhythmias.
  • Ventricular repolarization abnormalities are a concern in patients with coronary artery disease (CAD).

Purpose of the Study:

  • To compare the effects of mental stress on T wave amplitude and area between CAD patients and healthy controls.
  • To investigate the impact of nitroglycerine (NTG) on stress-induced repolarization changes in both groups.

Main Methods:

  • 14 healthy controls and 14 CAD patients underwent a mental stress protocol (arithmetic and speech) on two occasions (placebo and NTG).
  • 12-lead electrocardiograms were recorded, and T wave amplitude (T(amp)) and area (T(area)) were automatically measured.

Main Results:

  • Mental stress caused a decrease in T(amp) and T(area) in controls, but an increase in CAD patients (p < .001 for both arithmetic and speech).
  • Following NTG, the effect of mental stress on repolarization was similar in both groups, with a reversed effect observed in CAD patients.

Conclusions:

  • The response of ventricular repolarization to mental stress differs significantly between CAD patients and healthy individuals.
  • Nitroglycerine administration substantially mitigates the differential effects of mental stress on repolarization in CAD patients.
Abstract

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