Heart rate and blood pressure responses to mental stress and clinical cardiovascular events in men and women after coronary artery bypass grafting: The Post Coronary Artery Bypass Graft (Post-CABG) biobehavioral study
Heart rate and blood pressure responses to mental stress and clinical cardiovascular events in men and women after coronary artery bypass grafting: The Post Coronary Artery Bypass Graft (Post-CABG) biobehavioral study
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DOI：
10.1016/s0002-8703(03)00182-0
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发表时间：
2003-08-01
影响因子：
4.8
通讯作者：
Dupuis, G
中科院分区：
文献类型：
--
作者：
Herd, JA;Hoogwerf, BJ;Dupuis, G
研究背景冠状动脉旁路移植术（CABG）后生物行为学研究测量了近期接受CABG手术的患者术后心率（HR）和血压（BP）对心理应激测试（MST）的反应，并前瞻性观察了近期接受CABG手术的患者的临床事件。在CABG手术恢复心肌血流和防止心肌缺血的程度上，最近从CABG手术中恢复的患者对MST的HR和BP反应可能接近正常。（351人，170名女性）在镜像追踪测试（MTT）和言语测试任务（STT）。结果MTT和STT期间的HR和BP反应与其他研究中报道的健康人和MST期间无心肌缺血的患者相似。与冠状动脉疾病患者的其他研究结果相反，CABG后生物行为研究中，在MST期间HR、收缩压（SBP）和舒张压（DBP）反应最大的四分位数患者的临床事件发生率为一半（3年内10%）作为HR和BP变化最低的四分位数（20%）（HR，P =.01; SBP，P =.07; DBP，P = 0.01）结论MST对心率和血压的高反应可能是心血管事件发生率较低的标志，最近接受了CABG手术。
Background The Post-Coronary Artery Bypass Graft (CABG) biobehavioral study measured the heart rate (HR) and blood pressure (BP) responses to mental stress testing (MST) after surgery and prospectively observed the clinical events in patients who had undergone recent CABG surgery. To the extent that CABG surgery restores myocardial blood flow and prevents myocardial ischemia, patients who have recently recovered from CABG surgery may have nearly normal HR and BP responses to MST.Methods A study population of 521 patients (351 men, 170 women) from the cohort of 759 patients in the Post-CABG biobehavioral Study was monitored during a mirror tracing test (MTT) and a speech test task (STT) at the 6-month post-CABG surgery follow-up. Medical status for as long as 3 years after CABG surgery was ascertained from questionnaires and medical records.Results The HR and BP responses during MTT and STT were similar to those reported in other studies of healthy individuals and patients without myocardial ischemia during MST. In contrast to results from other studies of patients with coronary artery disease, the quartile of Post-CABG biobehavioral study patients with the greatest responses in HR, systolic BP (SBP) and diastolic BP (DBP) during MST had half the rate of clinical events (10% in 3 years) as the quartile (20%) with the lowest changes in HR and BP (HR, P =.01; SBP, P =.07; DBP, P =.01).Conclusions Vigorous HR and BP responses to MST may be markers for a lower risk of incidence of clinical cardiovascular events among patients who have undergone recent CABG surgery.