Study of psychosocial factors and endothelial dysfunction in coronary heart disease patients
Nan Tang1,2, Kangming Li1,2, Qingdui Zhang1
1Department of Cardiology, the Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Insights
Psychosocial factors like anxiety and depression are linked to endothelial dysfunction in coronary heart disease patients. Addressing these factors may improve vascular health and reduce cardiovascular event risk.
Area of Science:
- Cardiovascular Medicine
- Psychosomatic Medicine
- Clinical Research
Background:
- Coronary heart disease (CHD) poses a significant global health burden.
- Endothelial dysfunction is a key early event in atherosclerosis and CHD development.
- The role of psychosocial factors in influencing endothelial function in CHD patients requires further elucidation.
Purpose of the Study:
- To investigate the association between psychosocial factors and endothelial dysfunction in patients diagnosed with coronary heart disease.
- To identify specific psychosocial elements that contribute to endothelial dysfunction.
- To provide insights for the prevention and treatment strategies for CHD.
Main Methods:
- A cross-sectional study involving 200 CHD patients (100 with coronary stenosis ≥50%, 100 with normal coronary arteries <50%).
- Assessment of psychosocial factors using Type A Behaviour Pattern Scale (TABP), Self-Rating Anxiety Scale (SAS), Social Support Rating Scale (SSRS), and Self-Rating Depression Scale (SDS).
- Measurement of endothelial nitric oxide (NOx) synthesis and vasodilation functions (endothelium-dependent - EDF, and endothelium-independent - NEDF) via ELISA and color Doppler ultrasonography.
Main Results:
- Patients with coronary stenosis exhibited significantly higher Type A behavior, anxiety, and depression scores, and lower social support compared to the normal coronary group.
- Endothelial dysfunction markers (EDF, NEDF, NOx) were significantly lower in the coronary stenosis group.
- Psychosocial factors were negatively correlated with endothelial function indices, with Type A behavior, anxiety, depression, and social support identified as independent risk factors for endothelial dysfunction.
Conclusions:
- A significant relationship exists between psychosocial factors and endothelial dysfunction in patients with coronary heart disease.
- Interventions targeting psychosocial well-being are crucial for improving endothelial function.
- Strengthening the assessment and management of psychosocial factors may reduce the risk of cardiovascular events in CHD patients.
Objective:
To provide valuable insight into the prevention and treatment of coronary heart disease, this study aimed to explore the association between psychosocial elements and endothelial dysfunction in diagnosed patients.
Methods:
Using a cross-sectional study design, we selected patients with coronary heart disease who visited the cardiology department of our hospital from January to December 2021. According to coronary angiography results, patients were divided into the coronary stenosis group (≥50%) and the normal coronary group (<50%), with 100 cases in each group. We assessed the levels of psychosocial factors using the Type A Behaviour Pattern Scale (TABP), Self-Rating Anxiety Scale (SAS), Social Support Rating Scale (SSRS), and Self-Rating Depression Scale (SDS). Endothelial synthesis of nitric oxide (NOx) and endothelium-dependent (EDF) and endothelium-independent (NEDF) vasodilation functions were measured and compared using enzyme-linked immunosorbent assay (ELISA) and colour Doppler ultrasonography, respectively.
Results:
Patients in the coronary stenosis group had significantly higher scores in Type A behaviour, anxiety, and depression and significantly lower scores in social support compared with the normal coronary group (t = 3.21, 4.15, 3.87; p < 0.05; t = -2.96; p < 0.05). EDF, NEDF, and NOx levels were significantly lower in the coronary stenosis group than in the normal coronary group (t = -4.32, -3.76, -4.67; p < 0.05). Psychosocial factors were negatively correlated with endothelial function indices (r = -0.31 to -0.48; p < 0.05). Multiple linear regression analysis revealed that Type A behavioural anxiety, depression, and social support were independent risk factors influencing endothelial dysfunction (β = -0.23, -0.26, -0.21, -0.19; p < 0.05).
Conclusion:
A close relationship was observed between psychosocial factors and endothelial dysfunction in patients with coronary heart disease. Assessment and intervention of psychosocial factors in these patients should be strengthened to improve endothelial function and reduce the risk of cardiovascular events.
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