MENTAL STRESS, AUTONOMIC FUNCTION, AND HEART DISEASE

产品说明： 精神压力与心血管疾病的关系 冠状动脉疾病（CAD）患者的事件可能源于 由于血管紧张素过度增加， 阻力和动脉压。 事实上，这可以解释部分原因。 压力反射心脏迷走神经控制与预后的关系 冠心病患者的心血管结局。 血液动力学反应 通过动脉压力感受器反射缓冲心理压力;因此， 对精神压力的过度升压反应可能是由受损的 CAD患者的压力反射调节。 本提案的具体目标 是：1）表征血管硬度和 冠心病患者压力感受性反射调节的研究 CAD患者的受试者; 2）检查与个体相关的 压力感受器反射功能的神经源性估计的差异， 实验室心理学过程中自主神经和压力反射控制的变化 冠心病患者和健康对照者的压力; 3）测试 假设CAD患者的压力反射调节受损， 增加的血管硬度和/或减弱的自主控制， 与对心理压力的血流动力学反应加剧有关。 静脉推注血管活性药物联合Finapres逐搏输注 动脉压和颈动脉B型超声检查将用于 评估压力反射敏感性和动脉硬度。 压力反射 对心理压力的调整将通过功率进行评估 动脉压和心脏变时性之间频谱导出关系 在心算任务和演讲任务中。 的程度 压力反射功能的指数与血液动力学反应相关， 将评估CAD患者的心理压力。 没有数据 这将颈动脉或主动脉僵硬与心血管控制联系起来， 健康或CAD人群的精神压力。 因此，这项研究可能 提供了独特的洞察机制和心理生理相关性 CAD患者压力反射敏感性降低。

DESCRIPTION: The strong association between mental stress and morbid cardiovascular events in coronary artery disease (CAD) patients may derive from stress-induced cardiac ischemia due to exaggerated increases in vascular resistance and arterial pressure. In fact, this may explain part of the prognostic relationship of baroreflex cardiac vagal control to cardiovascular outcome among CAD patients. The hemodynamic responses to psychological stress are buffered by the arterial baroreflex; thus, exaggerated pressor responses to mental stress may result from impaired baroreflex regulation in CAD patients. The specific aims of this proposal are: 1) to characterize relationships between vascular stiffness and baroreflex regulation among CAD patients, also contrasting healthy control subjects with CAD patients; 2) to examine, in relation to individual differences in pharmacologically derived estimates of baroreflex function, changes in autonomic and baroreflex control during laboratory psychological stress among CAD patients and among healthy control subjects; 3) to test the hypothesis that impaired baroreflex regulation in CAD patients, due to increased vascular stiffness and/or attenuated autonomic control, is associated with exacerbated hemodynamic reactions to psychological stress. Bolus vasoactive drug infusions in combination with Finapres beat-by-beat arterial pressures and carotid B-mode ultrasonography will be used to evaluate baroreflex sensitivity and arterial stiffness. Baroreflex adjustments to psychological stress will be assessed by power spectral-derived relations between arterial pressure and cardiac chronotropy during a mental arithmetic task and a speech task. The degree to which indices of baroreflex function are associated with hemodynamic responses to psychological stress among CAD patients will be assessed. There are no data which related carotid or aortic stiffness to cardiovascular control during mental stress in healthy or CAD populations. Thus, this research may provide unique insight to the mechanism and psycho-physiological correlates of reduced baroreflex sensitivity in CAD patients.