An evidence of brain-heart disorder: mental stress-induced myocardial ischemia regulated by inflammatory cytokines

ABSTRACT

Objective

Underlying Coronary Artery Disease (CAD) complicated by Mental Stress-Induced Myocardial Ischemia (MSIMI) has been linked with an increased risk for adverse cardiovascular events and even sudden death. However, the underlying mechanisms of MSIMI remain unknown. In this study, we investigated cytokine levels at baseline inflammation status and during acute inflammatory responses to mental stress in patients with known CAD who presented with MSIMI.

Method

77 patients with known CAD were recruited and all underwent echocardiography before and during arithmetic stress task. MSIMI was diagnosed by new or worsening wall motion abnormalities greater than or equal to a 5% reduction of left ventricle ejection fraction. Inflammatory markers were measured both before and immediately after the Mental Stress (MS) by ELISA kits. Repeated measures models were used to report the responses and mixed linear regression models were used to report the differences between MSIMI negative and positive patients.

Result

MS induced a significant increase in Stromal Cell-Derived Factor-1α (SDF-1α) and Monocyte Chemoattractant Protein-1 (MCP-1) in all subjects; 20.78% of the patients with known CAD developed MSIMI during the arithmetic task. MSIMI positive patients had significantly lower baseline levels of Interleukin-1β (IL-1β) and Tumor Necrosis Factor-α (TNF-α), but a higher response in levels of SDF-1α than MSIMI negative patients.

Conclusion

MS can induce acute inflammatory responses. MSIMI is associated with lower levels of IL-1β and TNF-α at baseline and higher levels of SDF-1α in response to MS.

KEYWORDS:

• MSIMI
• CAD
• IL-1β
• TNF-α
• SDF-1α
• MCP-1

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by Beijing Municipal Science & Technology Commission, Project No. [Z151100003915085].

Notes on contributors

Meiyan Liu

Meiyan Liu is doctor and professor in cardiology in Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing China, and she has been specialized in studying psychocardiology for more than 20 years.

Jianyang Liu

Jianyang Liu is doctor in cardiology in Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing China.

Lijun Zhang

Lijun Zhang is doctor in cardiology in Beijing Anzhen Hospital  Affiliated to Capital Medical University, Beijing China.

Wan Xu

Wan Xu is doctor in cardiology in Beijing Anzhen Hospital  Affiliated to Capital Medical University, Beijing China.

Dongfang He

Dongfang He is a doctor in cardiology in Beijing Anzhen Hospital, Affiliated to Capital Medical University, Beijing China, and he is specialized in cardiac intervention surgery.

Wanlin Wei

Wanlin Wei is a doctor and professor in cardiology in PLA army General Hospital, Beijing, China.

Yingbin Ge

Yingbin Ge is a professor in physiology Nanjing Medical University, Jiangsu, China.

Chaitu Dandu

Chaitu Dandu is doctor in neurosurgery in Wayne State University School of Medicine, USA.