2020
Effects of Psychological Stress on Vascular Physiology: Beyond the Current Imaging Signal
Shah SM, Meadows JL, Burg MM, Pfau S, Soufer R. Effects of Psychological Stress on Vascular Physiology: Beyond the Current Imaging Signal. Current Cardiology Reports 2020, 22: 156. PMID: 33037500, DOI: 10.1007/s11886-020-01406-x.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsCardiovascular DiseasesCardiovascular SystemCoronary Artery DiseaseHumansMyocardial IschemiaStress, PsychologicalConceptsPsychological stressCardiovascular diseaseMental stress-induced myocardial ischemiaStress-induced myocardial ischemiaMental stressVascular smooth muscleMental stress effectsVascular systemCardiovascular imaging modalitiesEntire vascular systemCardiovascular manifestationsVascular effectsMicrovascular resistanceMicrovascular responsesVascular changesVascular mechanismsVascular responsesCardiovascular responsesMyocardial ischemiaLong-term consequencesSmooth muscleMicrovascular compartmentTherapeutic interventionsReviewThis reviewStandardized psychological assessmentsCardiovascular Imaging of Biology and Emotion
Meadows JL, Shah S, Burg MM, Pfau S, Soufer R. Cardiovascular Imaging of Biology and Emotion. Circulation Cardiovascular Imaging 2020, 13: e011054. PMID: 32762255, PMCID: PMC9261020, DOI: 10.1161/circimaging.120.011054.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsMental stressEpicardial coronary artery diseaseCoronary artery diseaseExercise-induced changesMicrovascular dysfunctionArtery diseaseObstructive diseaseClinical manifestationsVascular responsesCentral activationCardiovascular healthPathophysiologic changesCardiovascular responsesMyocardial ischemiaPeripheral vasculatureTreatment targetsVascular pathophysiologyPsychosocial determinantsCardiovascular imagingPsychosocial experiencesImplementation studyMS testingTriggers activationCardiovascular biologyDisease
2019
Effect of β-blockers on triggering of symptomatic atrial fibrillation by anger or stress
Lampert R, Burg MM, Jamner LD, Dziura J, Brandt C, Li F, Donovan T, Soufer R. Effect of β-blockers on triggering of symptomatic atrial fibrillation by anger or stress. Heart Rhythm 2019, 16: 1167-1173. PMID: 31171436, PMCID: PMC6759206, DOI: 10.1016/j.hrthm.2019.03.004.Peer-Reviewed Original ResearchConceptsAtrial fibrillationΒ-blockersAF episodesHistory of AFControl periodSymptomatic AF episodesSymptomatic atrial fibrillationΒ-blocker useExclusion of patientsPersistent atrial fibrillationHolter monitoringAF symptomsPatientsPatient exposureCase periodFibrillationMood statesEpisodesEvent monitorDeleterious physiological responsesExposurePhysiological responsesDiary dataSotalol
2014
Confluence of Depression and Acute Psychological Stress Among Patients With Stable Coronary Heart Disease: Effects on Myocardial Perfusion
Burg MM, Meadows J, Shimbo D, Davidson KW, Schwartz JE, Soufer R. Confluence of Depression and Acute Psychological Stress Among Patients With Stable Coronary Heart Disease: Effects on Myocardial Perfusion. Journal Of The American Heart Association 2014, 3: e000898. PMID: 25359402, PMCID: PMC4338683, DOI: 10.1161/jaha.114.000898.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedChi-Square DistributionChronic DiseaseConnecticutCoronary CirculationCoronary DiseaseDepressionFemaleHemodynamicsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisMyocardial Perfusion ImagingOdds RatioPredictive Value of TestsPsychiatric Status Rating ScalesRecurrenceRisk FactorsSeverity of Illness IndexStress, PsychologicalTomography, Emission-Computed, Single-PhotonConceptsAcute psychological stressMyocardial perfusionPsychological stressDepressed rangeNormal rangeAcute coronary syndrome (ACS) recurrenceSelective serotonin reuptake inhibitor medicationsStable coronary heart diseaseCoronary heart disease patientsSerotonin reuptake inhibitor medicationsImpaired myocardial perfusionTomography myocardial perfusionCoronary heart diseaseMortality risk factorsOptimal medical careHigh normal rangeReuptake inhibitor medicationsHeart disease patientsBeck Depression InventorySingle photon emissionACS recurrenceCHD prognosisInhibitor medicationVascular mechanismsMeasures of depressionTriggering of Symptomatic Atrial Fibrillation by Negative Emotion
Lampert R, Jamner L, Burg M, Dziura J, Brandt C, Liu H, Li F, Donovan T, Soufer R. Triggering of Symptomatic Atrial Fibrillation by Negative Emotion. Journal Of The American College Of Cardiology 2014, 64: 1533-1534. PMID: 25277622, DOI: 10.1016/j.jacc.2014.07.959.Peer-Reviewed Original Research
2013
Therapy for Mental Stress–Induced Myocardial Ischemia
Burg MM, Soufer R. Therapy for Mental Stress–Induced Myocardial Ischemia. JAMA 2013, 310: 1400-1401. PMID: 24084926, DOI: 10.1001/jama.2013.277951.Peer-Reviewed Original Research
2011
Cardiac repolarization instability during psychological stress in patients with ventricular arrhythmias
Abisse SS, Lampert R, Burg M, Soufer R, Shusterman V. Cardiac repolarization instability during psychological stress in patients with ventricular arrhythmias. Journal Of Electrocardiology 2011, 44: 678-683. PMID: 21920534, PMCID: PMC3200452, DOI: 10.1016/j.jelectrocard.2011.07.019.Peer-Reviewed Original ResearchConceptsSubsequent ventricular tachyarrhythmiasVentricular tachyarrhythmiasGroup 2Group 1Life-threatening ventricular tachyarrhythmiasPsychological stressSubsequent arrhythmic eventsAutonomic nervous system activityNervous system activityCardiac repolarization instabilityICD implantationVentricular arrhythmiasArrhythmic eventsQT intervalRepolarization responseCardiac repolarizationHeart ratePatientsT-wave areaPsychological stressorsMental stressRepolarization instabilityCardiac physiologySystem activitySignificant differences
2010
Tendency to Angry Rumination Predicts Stress-Provoked Endothelin-1 Increase in Patients With Coronary Artery Disease
Fernandez AB, Soufer R, Collins D, Soufer A, Ranjbaran H, Burg MM. Tendency to Angry Rumination Predicts Stress-Provoked Endothelin-1 Increase in Patients With Coronary Artery Disease. Psychosomatic Medicine 2010, 72: 348-353. PMID: 20368479, PMCID: PMC2872076, DOI: 10.1097/psy.0b013e3181d71982.Peer-Reviewed Original ResearchConceptsCoronary heart diseaseET-1 increaseET-1Chronic stable coronary heart diseaseStable coronary heart diseaseMultivariate logistic regression modelET-1 elevationAcute coronary syndromeHistory of diabetesRate-pressure productCoronary artery diseaseEndothelin-1 increaseLogistic regression modelsCoronary syndromeArtery diseaseBeta blockersPotential confoundersPressure productHeart diseasePlaque ruptureBlood samplesPatientsAngry ruminationNitric oxideStress protocol
2009
Heart-brain interactions in mental stress-induced myocardial ischemia
Soufer R, Jain H, Yoon AJ. Heart-brain interactions in mental stress-induced myocardial ischemia. Current Cardiology Reports 2009, 11: 133-140. PMID: 19236829, PMCID: PMC3726062, DOI: 10.1007/s11886-009-0020-1.Peer-Reviewed Original ResearchConceptsMental stress ischemiaStress ischemiaMyocardial ischemiaMental stress-induced myocardial ischemiaStress-induced myocardial ischemiaCoronary artery diseaseCentral nervous systemHeart-brain interactionsArtery diseasePoor prognosisAutonomic balancePathophysiologic underpinningsTreatment strategiesNervous systemIschemiaPsychosocial stressBiobehavioral aspectsBiobehavioral modelBiologic consequencesSensory inputBiologic processesBrainEmotional provocationPatientsPrognosisAnger-Induced T-Wave Alternans Predicts Future Ventricular Arrhythmias in Patients With Implantable Cardioverter-Defibrillators
Lampert R, Shusterman V, Burg M, McPherson C, Batsford W, Goldberg A, Soufer R. Anger-Induced T-Wave Alternans Predicts Future Ventricular Arrhythmias in Patients With Implantable Cardioverter-Defibrillators. Journal Of The American College Of Cardiology 2009, 53: 774-778. PMID: 19245968, PMCID: PMC3979284, DOI: 10.1016/j.jacc.2008.10.053.Peer-Reviewed Original ResearchConceptsVentricular tachycardia/ventricular fibrillationFuture ventricular arrhythmiasT-wave alternansVentricular arrhythmiasVentricular fibrillationSpontaneous ventricular tachycardia/ventricular fibrillationHigher TWAImplantable cardioverter defibrillatorEjection fractionHighest quartileTWA testingWide QRSClinical arrhythmiaAmbulatory electrocardiographyLowest quartileFuture arrhythmiasSudden deathCardioverter defibrillatorClinical roleMultivariable regressionPatientsArrhythmiasRepolarization instabilityStress protocolSignificant predictors
2008
Noninvasive Detection of Risk for Emotion Provoked Myocardial Ischemia
Burg MM, Graeber B, Vashist A, Collins D, Earley C, Liu J, Lampert R, Soufer R. Noninvasive Detection of Risk for Emotion Provoked Myocardial Ischemia. Psychosomatic Medicine 2008, 71: 14-20. PMID: 18941131, PMCID: PMC2739989, DOI: 10.1097/psy.0b013e318187c035.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngerAngiotensin-Converting Enzyme InhibitorsBlood PressureCoronary DiseaseEpinephrineFemaleHeart RateHumansImagery, PsychotherapyMaleManometryMiddle AgedMyocardial IschemiaNorepinephrinePlethysmographyPredictive Value of TestsPulsatile FlowRiskSensitivity and SpecificityStress, PsychologicalTomography, Emission-Computed, Single-PhotonVascular ResistanceConceptsPeripheral arterial tonometryCoronary artery diseasePAT ratioMyocardial ischemiaMajor adverse cardiac eventsStable coronary artery diseaseLower PAT ratioMental stress ischemiaAdverse cardiac eventsNew perfusion defectsCT myocardial perfusionSensitivity/specificityStress ischemiaArterial tonometryCardiac eventsArtery diseaseBlood pressureACE inhibitionPerfusion defectsHeart rateMyocardial perfusionPatientsEnzyme inhibitorsClinical settingIschemia
2007
Psychological Stress and Myocardial Ischemia: Understanding the Link and the Implications
Sheps DS, Soufer R, Freedland KE. Psychological Stress and Myocardial Ischemia: Understanding the Link and the Implications. Psychosomatic Medicine 2007, 69: 491-492. PMID: 17641143, DOI: 10.1097/psy.0b013e31814527c2.Peer-Reviewed Original ResearchMental stress–induced myocardial ischemia: Moving forward
Burg MM, Soufer R. Mental stress–induced myocardial ischemia: Moving forward. Journal Of Nuclear Cardiology 2007, 14: 269-271. PMID: 17556157, DOI: 10.1016/j.nuclcard.2007.04.009.Peer-Reviewed Original ResearchThe heart-brain interaction during emotionally provoked myocardial ischemia: implications of cortical hyperactivation in CAD and gender interactions.
Soufer R, Burg MM. The heart-brain interaction during emotionally provoked myocardial ischemia: implications of cortical hyperactivation in CAD and gender interactions. Cleveland Clinic Journal Of Medicine 2007, 74 Suppl 1: s59-62. PMID: 17455547, DOI: 10.3949/ccjm.74.suppl_1.s59.Peer-Reviewed Original ResearchConceptsMental stress-induced ischemiaStress-induced ischemiaMental stressMyocardial ischemiaAcute coronary syndromeRecurrent cardiac eventsSilent myocardial ischemiaRisk stratification algorithmLong-term outcomesTreatment of patientsHeart-brain interactionsDifferential pathophysiologyCoronary syndromeCardiac eventsRisk stratificationPoor prognosisTransient ischemiaVulnerable patientsStratification algorithmCortical hyperactivationEarly deathIschemiaDiagnostic testingClinical settingClinical goals
2006
C-Reactive Protein and Vulnerability to Mental Stress-Induced Myocardial Ischemia
Shah R, Burg MM, Vashist A, Collins D, Liu J, Jadbabaie F, Graeber B, Earley C, Lampert R, Soufer R. C-Reactive Protein and Vulnerability to Mental Stress-Induced Myocardial Ischemia. Molecular Medicine 2006, 12: 269-274. PMID: 17380191, PMCID: PMC1829194, DOI: 10.2119/2006-00077.shah.Peer-Reviewed Original ResearchConceptsC-reactive proteinCoronary artery diseaseMyocardial perfusion imagingTransthoracic echocardiographyCRP levelsMental stressRisk markersMyocardial ischemiaLevels of CRPNew regional wall motion abnormalitiesAssociation of CRPRelationship of CRPSimultaneous single-photon emissionStable coronary artery diseaseUnivariate logistic regression analysisRegional wall motion abnormalitiesTetrofosmin myocardial perfusion imagingLaboratory mental stressRisk of MSISerum CRP levelsHistory of diabetesSubsequent clinical eventsNew perfusion defectsWall motion abnormalitiesLogistic regression analysis
2005
Mental stress ischemia: Present status and future goals
Burg MM, Vashist A, Soufer R. Mental stress ischemia: Present status and future goals. Journal Of Nuclear Cardiology 2005, 12: 523-529. PMID: 16171711, DOI: 10.1016/j.nuclcard.2005.06.085.Peer-Reviewed Original ResearchMeSH KeywordsBiomedical ResearchHumansMyocardial IschemiaPractice Patterns, Physicians'PrognosisStress, PsychologicalConceptsEvent-free survival rateLarge-scale clinical trialsAssessment of prognosisForms of ischemiaComplex clinical manifestationsSubstantial clinical impactClinical manifestationsPrognostic significanceClinical trialsClinical impactSurvival rateDiagnostic standardizationTreatment effectsIschemiaNuclear cardiologyPrognosisPathophysiologySufficient evidenceAdditional modalitiesTrialsFurther testingTreatmentPrevalenceCardiologyEffects of Psychologic Stress on Repolarization and Relationship to Autonomic and Hemodynamic Factors
LAMPERT R, SHUSTERMAN V, BURG MM, LEE FA, EARLEY C, GOLDBERG A, MCPHERSON CA, BATSFORD WP, SOUFER R. Effects of Psychologic Stress on Repolarization and Relationship to Autonomic and Hemodynamic Factors. Journal Of Cardiovascular Electrophysiology 2005, 16: 372-377. PMID: 15828878, DOI: 10.1046/j.1540-8167.2005.40580.x.Peer-Reviewed Original ResearchConceptsT-wave alternansMental stressVentricular arrhythmiasPsychological stressAmbulatory ECG monitoringT-wave amplitudePathophysiologic linkSusceptible patientsSystolic BPRepolarization indicesAlters indicesPsychologic stressRepolarization changesSudden deathPatientsHemodynamic factorsT-wave areaStress protocolECG monitoringArrhythmiasPhysiologic pathwaysRepolarizationMyocardial heterogeneityICDHr
2004
Neurocardiac Interaction During Stress-Induced Myocardial Ischemia
Soufer R. Neurocardiac Interaction During Stress-Induced Myocardial Ischemia. Circulation 2004, 110: 1710-1713. PMID: 15451806, DOI: 10.1161/01.cir.0000144841.84987.50.Peer-Reviewed Original Research
2003
Simultaneous assessment of myocardial perfusion and function during mental stress in patients with chronic coronary artery disease
Arrighi JA, Burg M, Cohen IS, Soufer R. Simultaneous assessment of myocardial perfusion and function during mental stress in patients with chronic coronary artery disease. Journal Of Nuclear Cardiology 2003, 10: 267-274. PMID: 12794625, DOI: 10.1016/s1071-3581(02)43235-7.Peer-Reviewed Original ResearchConceptsMyocardial perfusion imagingChronic coronary artery diseaseLeft ventricular dysfunctionVentricular dysfunctionCoronary artery diseaseReversible perfusion defectsPerfusion defectsArtery diseaseVentricular functionMyocardial perfusionNew regional wall motion abnormalitiesSestamibi single-photon emissionPharmacologic stress myocardial perfusion imagingStress myocardial perfusion imagingGlobal left ventricular dysfunctionRegional wall motion abnormalitiesResultsTwenty-eight patientsLeft ventricular functionWall motion abnormalitiesTomography (SPECT) MPIMyocardial perfusion defectsRegional wall motionCircumferential profile analysisSingle photon emissionSimultaneous assessment
2002
Brain, behavior, mental stress, and the neurocardiac interaction
Soufer R, Arrighi JA, Burg MM. Brain, behavior, mental stress, and the neurocardiac interaction. Journal Of Nuclear Cardiology 2002, 9: 650-662. PMID: 12466790, DOI: 10.1067/mnc.2002.129884.Peer-Reviewed Original Research