Low hot pain threshold predicts shorter time to exercise-induced angina: results from the psychophysiological investigations of myocardial ischemia (PIMI) study.
Low hot pain threshold predicts shorter time to exercise-induced angina: results from the psychophysiological investigations of myocardial ischemia (PIMI) study.
复制标题
低热痛阈值预测运动诱发心绞痛的时间较短：心肌缺血 (PIMI) 研究的心理生理学调查结果。
DOI：
10.1016/s0735-1097(99)00099-6
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发表时间：
1999
影响因子：
24
通讯作者：
Kaufmann,PG
中科院分区：
文献类型：
--
作者：
Sheps,DS;McMahon,RP;Light,KC;Maixner,W;Pepine,CJ;Cohen,JD;Goldberg,AD;Bonsall,R;Carney,R;Stone,PH;Sheffield,D;Kaufmann,PG
结果本研究的目的是测试是否皮肤热痛阈值与心绞痛pain perception. A相关的一些缺血性发作与心绞痛;症状已与pain perception thresholds.METHODSA共196例有记录的冠状动脉疾病患者进行了自行车运动试验和热痛试验。在两天休息30分钟后以及运动和精神压力后，在基线时进行皮肤感觉知觉的Marstock测试。对两次基线访视的静息热痛阈值（HPT）取平均值，并分为两组：1）平均HPT <41°C，2）平均HPT ≥41°C，以明确指示对有害热的异常超敏反应。HPT <41°C的患者在运动试验中至心绞痛发作的时间显著短于HPT ≥41°C的患者（p < 0.04，对数秩检验）。心率、收缩压和心率-血压乘积在峰值运动时两组无差异。HPT <41°C组的静息血浆β-内啡肽水平显著更高（5.9 ± 3.7 pmol/L vs. 4.7 ± 2.8 pmol/L，p = 0.02）。使用考克斯比例风险模型，HPT <41°C的患者心绞痛风险增加（p = 0.03，率比= 2.0）。这些差异在调整年龄、性别、抑郁、焦虑和糖尿病或高血压史后仍然存在（p < 0.01）。结论心绞痛的发生和运动试验中心绞痛发作的时间与总体热痛感觉有关。这种关系的机制需要进一步研究。
OBJECTIVESThe purpose of this study was to test whether cutaneous thermal pain thresholds are related to anginal pain perception.BACKGROUNDFew ischemic episodes are associated with angina; symptoms have been related to pain perception thresholds.METHODSA total of 196 patients with documented coronary artery disease underwent bicycle exercise testing and thermal pain testing. The Marstock test of cutaneous sensory perception was administered at baseline after 30 min of rest on two days and after exercise and mental stress. Resting hot pain thresholds (HPTs) were averaged for the two baseline visits and divided into two groups: 1) average HPT <41°C, and 2) average HPT ≥41°C, to be clearly indicative of abnormal hypersensitivity to noxious heat.RESULTSPatients with HPT <41°C had significantly shorter time to angina onset on exercise testing than patients with HPT ≥41°C (p < 0.04, log-rank test). Heart rates, systolic blood pressure and rate–pressure product at peak exercise were not different for the two groups. Resting plasma beta-endorphin levels were significantly higher in the HPT <41°C group (5.9 ± 3.7 pmol/liter vs. 4.7 ± 2.8 pmol/liter, p = 0.02). Using a Cox proportional hazards model, patients with HPT <41°C had an increased risk of angina (p = 0.03, rate ratio = 2.0). These differences persisted after adjustment for age, gender, depression, anxiety and history of diabetes or hypertension (p < 0.01).CONCLUSIONSOccurrence of angina and timing of angina onset on an exercise test are related to overall hot pain sensory perception. The mechanism of this relationship requires further study.