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Quantitation of diffuse myocardial ischemia with mental stress and its association with cardiovascular events in individuals with recent myocardial infarction.
Almuwaqqat, Zakaria; Garcia, Ernest V; Cooke, C David; Garcia, Mariana; Shah, Amit J; Elon, Lisa; Ko, Yi-An; Sullivan, Samaah; Nye, Jonathon; Van Assen, Marly; De Cecco, Carlo; Raggi, Paolo; Bremner, J Douglas; Quyyumi, Arshed A; Vaccarino, Viola.
Afiliación
  • Almuwaqqat Z; Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA. zalmuwa@emory.edu.
  • Garcia EV; Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA. zalmuwa@emory.edu.
  • Cooke CD; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
  • Garcia M; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
  • Shah AJ; Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA.
  • Elon L; Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
  • Ko YA; Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA.
  • Sullivan S; Atlanta VA Medical Center, Decatur, GA, USA.
  • Nye J; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
  • Van Assen M; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
  • De Cecco C; Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
  • Raggi P; Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Sciences Center, Houston, TX, USA.
  • Bremner JD; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
  • Quyyumi AA; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
  • Vaccarino V; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
J Nucl Cardiol ; 30(5): 2029-2038, 2023 10.
Article en En | MEDLINE | ID: mdl-36991249
Microcirculatory dysfunction during psychological stress may lead to diffuse myocardial ischemia. We developed a novel quantification method for diffuse ischemia during mental stress (dMSI) and examined its relationship with outcomes after a myocardial infarction (MI). We studied 300 patients ≤ 61 years of age (50% women) with a recent MI. Patients underwent myocardial perfusion imaging with mental stress and were followed for 5 years. dMSI was quantified from cumulative count distributions of rest and stress perfusion. Focal ischemia was defined in a conventional fashion. The main outcome was a composite outcome of recurrent MI, heart failure hospitalizations, and cardiovascular death. A dMSI increment of 1 standard deviation was associated with a 40% higher risk for adverse events (HR 1.4, 95% CI 1.2-1.5). Results were similar after adjustment for viability, demographic and clinical factors and focal ischemia. In sex-specific analysis, higher levels of dMSI (per standard deviation increment) were associated with 53% higher risk of adverse events in women (HR 1.5, 95% CI 1.2-2.0) but not in men (HR 0.9, 95% CI 0.5-1.4), P 0.001. A novel index of diffuse ischemia with mental stress was associated with recurrent events in women but not in men after MI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Isquemia Miocárdica / Infarto del Miocardio Tipo de estudio: Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: J Nucl Cardiol Asunto de la revista: CARDIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Isquemia Miocárdica / Infarto del Miocardio Tipo de estudio: Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: J Nucl Cardiol Asunto de la revista: CARDIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos