The pathophysiology of mental stress induced myocardial ischaemia
Research type
Research Study
Full title
Comparison of the pathophysiological aetiology of exercise vs mental stress-induced myocardial ischaemia.
IRAS ID
141633
Contact name
Simon Redwood
Contact email
Sponsor organisation
King's College London
Research summary
Coronary artery disease remains the leading cause of morbidity and mortality in the United Kingdom. Angina is described as a heavy or tight pain in the chest caused by lack of blood supply to the heart muscle. It usually occurs when arteries that supply the heart become narrowed. The pain is often triggered by physical activity, although many patients also develop angina following periods of emotional stress. A heart attack occurs when there is a sudden total blockage of a coronary artery.
Emotional stress caused by publicised national sports events and natural disasters such as earthquakes has been associated with an increase in the number of heart attacks. In contrast, even in patients with known coronary artery disease and exertional angina, exercise is safe and beneficial. Recently our research group has successfully quantified coronary artery blood flow and central blood pressure changes during exercise. This was performed in the catheter laboratory, immediately before patients were operated on to have their narrowed or blocked heart arteries treated.
Some studies to date have suggested that the mechanisms that cause angina due to mental stress differ to those that cause angina secondary to exercise. We intend to investigate these mechanisms using novel cardiac MRI scans and invasive coronary flow studies while patients undergo exercise or are exposed to a degree of mental stress. This study will enable us to precisely quantify the effect of mental stress on coronary artery blood flow and central blood pressure and compare the changes seen with exercise.The results of this study will be of great interest to the cardiovascular community. A greater understanding of the mechanisms that trigger angina in response to emotional and mental stress may allow future tailored treatments.
REC name
London - London Bridge Research Ethics Committee
REC reference
13/LO/1875
Date of REC Opinion
30 Jan 2014
REC opinion
Further Information Favourable Opinion