1998 Volume 62 Issue 3 Pages 173-177
Mental stress is an important factor affecting cardiac function. We evaluated the effect of a mental calculation stress (MS) test on hemodynamics and left ventricular (LV) diastolic function in patients with ischemic heart disease, and compared the hemodynamic responses with a treadmill exercise test. Fifteen patients were studied. Seven had old myocardial infarction with significant coronary artery stenosis (group I) and 8 had chest pain syndrome with non-significant coronary artery stenosis (group II) . The MS test was performed as follows: after memorizing 6 random numeral digits, patients repeated these numbers in reverse order for 5 min followed by serial subtraction of 1000 minus 17 for 5 min. Blood pressure (BP) and heart rate (HR) were measured every 1-5 min. Doppler mitral flow velocity (MFV) was recorded every 2-5 min. During the MS test, BP, HR, and rate pressure product increased by 38.3%, 17.3%, and 62.1% on average, respectively. Early diastolic MFV decreased by 10.0% in group I and 3.3% in group II. First third filling rate of MFV decreased by 32.3% in group I and 22.8% in group II. A/E ratio increased by 39.3% in group I and 25.8% in group II. These data indicate that the MS test led to a deterioration in LV diastolic function. The MS test induced LV diastolic dysfunction to a greater extent in patients with significant coronary artery stenosis than in those without significant coronary stenosis. Myocardial ischemia may be induced by increased left ventricular afterload and/or vasoconstrictive reflex of coronary microcirculation. (Jpn Circ J 1998; 62: 173 - 177)
