2020
The Foundational Role of Cardiovascular Imaging in the Characterization of Mental Stress–Induced Myocardial Ischemia in Patients with Coronary Artery Disease
Meadows JL, Shah S, Burg MM, Pfau S, Soufer R. The Foundational Role of Cardiovascular Imaging in the Characterization of Mental Stress–Induced Myocardial Ischemia in Patients with Coronary Artery Disease. Current Cardiology Reports 2020, 22: 162. PMID: 33037938, DOI: 10.1007/s11886-020-01407-w.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsCoronary artery diseaseArtery diseaseMyocardial ischemiaMental Stress–Induced Myocardial IschemiaNon-obstructive coronary artery diseaseStable coronary artery diseaseHalf of patientsEpicardial coronary stenosisMental stress testingMyocardial oxygen demandUnderstanding of pathophysiologyCoronary macroAnginal symptomsCardiac eventsAdverse prognosisEarly mortalityIschemic phenomenaCoronary perfusionCoronary stenosisCoronary microvasculatureInvasive studiesClinical careMyocardial perfusionStress-mediated changesCardiac responseEffects 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 StatementsConceptsPsychological 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
2016
Body Mass Index and Risk for Mental Stress-Induced Ischemia in Coronary Artery Disease
Soufer R, Fernandez AB, Meadows J, Collins D, Burg MM. Body Mass Index and Risk for Mental Stress-Induced Ischemia in Coronary Artery Disease. Molecular Medicine 2016, 22: 286-291. PMID: 27261777, PMCID: PMC5023512, DOI: 10.2119/molmed.2016.00128.Peer-Reviewed Original ResearchBody mass indexHigher body mass indexMental stressMass indexChronic inflammationAutonomic dysregulationMyocardial ischemiaTraditional coronary artery disease risk factorsConfidence intervalsCoronary artery disease risk factorsMean body mass indexGreater body mass indexLaboratory mental stressHistory of hypertensionIndependent risk markerDisease risk factorsProspective interventional studyCoronary artery diseaseMultivariate logistic regressionMyocardial blood flowSingle photon emissionStress–Induced IschemiaCAD mortalityElevated markersStable CAD
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 provocationPatientsPrognosis
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
The 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
2004
Differential impact of parasympathetic withdrawal to mental stress ischemia as assessed by noninvasive evaluation of myocardial perfusion and/or function
Vashist A, Arrighi J, Lampert R, Burg M, Soufer R. Differential impact of parasympathetic withdrawal to mental stress ischemia as assessed by noninvasive evaluation of myocardial perfusion and/or function. Journal Of Nuclear Cardiology 2004, 11: s21. DOI: 10.1016/j.nuclcard.2004.06.068.Peer-Reviewed Original ResearchChronic coronary artery diseaseRegional LV dysfunctionMyocardial ischemiaParasympathetic withdrawalLV dysfunctionChronic chronic coronary artery diseaseMental stress ischemiaRate-pressure productCoronary artery diseaseGreater parasympathetic withdrawalHigh-frequency powerStress ischemiaArtery diseaseNon-invasive imagingMPI defectsSympathovagal balanceIndividual patientsSPECT-MPIIschemiaMyocardial perfusionNoninvasive evaluationPatientsMental arithmetic taskAutonomic responsesSPECT defects
2000
Persistent Changes in Myocardial Glucose Metabolism In Vivo During Reperfusion of a Limited-Duration Coronary Occlusion
McNulty P, Jagasia D, Cline G, Ng C, Whiting J, Garg P, Shulman G, Soufer R. Persistent Changes in Myocardial Glucose Metabolism In Vivo During Reperfusion of a Limited-Duration Coronary Occlusion. Circulation 2000, 101: 917-922. PMID: 10694532, DOI: 10.1161/01.cir.101.8.917.Peer-Reviewed Original ResearchConceptsCoronary occlusionGlucose metabolismPostischemic stunningAnterolateral left ventricleHeart glucose metabolismCoronary artery occlusionRegional glucose metabolismMyocardial glucose metabolismRegional myocardial ischemiaRegional mechanical functionRapid reperfusionReversible coronary occlusionArtery occlusionMyocardial ischemiaIntact ratsPreferential shuntingBlood flowReperfusionTracer uptakeLeft ventricleGlycogen depletionMetabolic signaturesOcclusionPersistent changesSustained changes
1998
Cerebral cortical hyperactivation in response to mental stress in patients with coronary artery disease
Soufer R, Bremner J, Arrighi J, Cohen I, Zaret B, Burg M, Goldman-Rakic P. Cerebral cortical hyperactivation in response to mental stress in patients with coronary artery disease. Proceedings Of The National Academy Of Sciences Of The United States Of America 1998, 95: 6454-6459. PMID: 9600987, PMCID: PMC27794, DOI: 10.1073/pnas.95.11.6454.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseVisual association cortexSuperior frontal gyrusRight visual association cortexCAD patientsHealthy subjectsPositron emission tomographyMental stressAssociation cortexFrontal gyrusArtery diseaseMyocardial ischemiaAnterior cingulateCentral nervous system effectsCAD patient groupCerebral cortical responsePainless myocardial ischemiaNervous system effectsLeft parietal cortexInferior parietal lobuleMiddle temporal gyrusPatient groupSerial subtraction taskRight thalamusInferior frontal gyrus
1993
Role of behavioral and psychological factors in mental stress-induced silent left ventricular dysfunction in coronary artery disease
Burg M, Jain D, Soufer R, Kerns R, Zaret B. Role of behavioral and psychological factors in mental stress-induced silent left ventricular dysfunction in coronary artery disease. Journal Of The American College Of Cardiology 1993, 22: 440-448. PMID: 8335813, DOI: 10.1016/0735-1097(93)90048-6.Peer-Reviewed Original ResearchConceptsSilent left ventricular dysfunctionLeft ventricular dysfunctionCoronary artery diseaseVentricular dysfunctionArtery diseaseBlood pressureChronic stable coronary artery diseaseStable coronary artery diseaseStress thallium-201 imagingMental stressGroup I patientsSilent myocardial ischemiaThallium-201 imagingAbsence of symptomsSerial radionuclide ventriculographyStructured interviewsNonischemic groupEjection fractionI patientsPsychological factorsVentricular indexRadionuclide ventriculographyClinical indicesMyocardial ischemiaReversible defects