Board examination stress effect on diastolic function.

Area of Science:

• Cardiology
• Psychocardiology
• Medical Education

Background:

• The direct impact of mental stress on cardiac diastolic function remains under-investigated.
• Previous research indicates stress affects cardiovascular health through hemodynamic and neuroendocrine pathways.
• This study specifically examines the influence of Board Exam anxiety on heart function.

Purpose of the Study:

• To assess the role of Board Exam anxiety on right and left ventricular diastolic function.
• To investigate changes in cardiac function in medical residents before and after a high-stress event.
• To correlate anxiety levels with alterations in diastolic parameters.

Main Methods:

• Forty medical residents were evaluated using Doppler echocardiography before and two months after their board exam.
• Right and left ventricular systolic and diastolic functions were assessed.
• Anxiety levels were quantified using the Beck Anxiety Inventory Questionnaire.

Main Results:

• Significant increases in mitral inflow velocity (E/A ratio) for both left and right ventricles were observed post-exam (P < .001 and P = .002, respectively).
• A significant decrease in septal wall early mitral inflow to annular velocity (E/E') was noted post-exam (P < .001).
• Tricuspid annulus velocity and mitral annular velocities increased post-exam (P < .05), with trends suggesting greater changes in high-stress groups.

Conclusions:

• This study provides the first comprehensive assessment of ventricular diastolic function during a real-world stress event.
• Reduced E/A and E' ratios in response to mental stress suggest a potential mechanism for stress-induced diastolic dysfunction.
• Repetitive mental stress may contribute to diastolic dysfunction, a risk factor for heart failure.