BEHAVIORAL STRESS AND MYOCARDIAL ISCHEMIA

心理因素在这两种疾病的发展中都有牵连 冠状动脉疾病和心律失常。然而， 行为和心脏病之间的病理生理联系尚未得到证实 已经成立了。冠脉血流调节的变化 严重的情绪压力情况可能对此有很大影响 进程。我最近证明了一种可控的行为压力 会引起α-肾上腺素能受体介导的冠脉血管收缩 (4，5)。以类似的方式，已经证明在 冷加压试验的实施，已存在的患者 冠状动脉疾病表现出明显更大的增加 冠脉阻力高于健康对照组(12，13)。因此， 既往存在的冠状动脉疾病可能会加剧这种行为 诱导的冠状动脉血管收缩，可能触发血管痉挛 血管闭塞。因此，建议的目的是 一系列实验来调查心理和心理之间的相互作用 冠状动脉应激与心肌缺血、梗死或血管狭窄 血液流动调节。简而言之，使用多学科方法 将使用行为、生理和药理学技术。 产生稳定和刻板印象的经典厌恶条件反射 心血管反应模式将作为应激的模型。这个 介导冠状动脉反应的机制将由 谨慎应用特定的药物和外科治疗。 此外，该模型还提供了调查 心肌缺血损伤与行为应激的相互作用 心律失常。

Psychological factors have been implicated in both the development of coronary artery disease and cardiac arrhythmias. However, the pathophysiological link between behavior and heart disease has yet to be established. Alterations in the regulation of coronary blood flow during acute emotionally stressful situations may contribute significantly to this process. I have recently demonstrated that a controlled behavioral stress will elicit an alpha-adrenergic receptor mediated coronary vasoconstriction (4,5). In a similar manner, it has been demonstrated that during the administration of the cold pressor test, patients with pre-existing coronary artery disease exhibited a significantly greater increase in coronary vascular resistance than did healthy controls (12,13). Thus, pre-existing coronary vessel disease may exacerbate this behaviorally induced coronary vasoconstriction, possibly triggering a vasospastic occlusion of the vessel. It is, therefore, the purpose of the proposed series of experiments to investigate the interaction between psychological stress and myocardial ischemia, infarction, or vessel stenosis on coronary blood flow regulation. Briefly, a multidisciplinary approach using behavioral, physiological and pharmacological techniques will be employed. Classical aversive conditioning which produces a stable and stereotypic cardiovascular response pattern will serve as a model of stress. The mechanisms mediating the coronary response will be determined by the careful application of specific pharmacological and surgical treatments. In addition, this model presents the opportunity to investigate the interaction between myocardial ischemic injury and behavioral stress on arrhythmogenesis.