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 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
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
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 analysisThe Implications of Mental Stress for Cardiovascular Disease
Graeber B, Soufer A, Burg M, Soufer R. The Implications of Mental Stress for Cardiovascular Disease. Contemporary Cardiology 2006, 197-215. DOI: 10.1007/978-1-59745-096-6_11.Peer-Reviewed Original Research
2005
Effects 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
2001
7.44 Simultaneous assessment of myocardial perfusion and function during mental stress in patients with chronic coronary artery disease
Arrighi J, Burg M, Cohen I, Soufer R. 7.44 Simultaneous assessment of myocardial perfusion and function during mental stress in patients with chronic coronary artery disease. Journal Of Nuclear Cardiology 2001, 8: s51. DOI: 10.1016/s1071-3581(01)80621-8.Peer-Reviewed Original Research
2000
Myocardial blood-flow response during mental stress in patients with coronary artery disease
Arrighi J, Burg M, Cohen I, Kao A, Pfau S, Caulin-Glaser T, Zaret B, Soufer R. Myocardial blood-flow response during mental stress in patients with coronary artery disease. The Lancet 2000, 356: 310-311. PMID: 11071190, DOI: 10.1016/s0140-6736(00)02510-1.Peer-Reviewed Original Research
1999
Myocardial blood flow decreases during mental stress independent of vasodilator capacity/severity of CAD
Arrighi J, Burg M, Cohen I, Bremner D, Zaret B, Soufer R. Myocardial blood flow decreases during mental stress independent of vasodilator capacity/severity of CAD. Journal Of Nuclear Cardiology 1999, 6: s12. DOI: 10.1016/s1071-3581(99)90162-9.Peer-Reviewed Original Research
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 gyrusEffects of Mental Stress on Left Ventricular and Peripheral Vascular Performance in Patients With Coronary Artery Disease
Jain D, Shaker M, Burg M, Wackers F, Soufer R, Zaret B. Effects of Mental Stress on Left Ventricular and Peripheral Vascular Performance in Patients With Coronary Artery Disease. Journal Of The American College Of Cardiology 1998, 31: 1314-1322. PMID: 9581726, DOI: 10.1016/s0735-1097(98)00092-8.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionPeripheral vascular resistanceCoronary artery diseaseRate-pressure productStress-induced fallSystolic blood pressureArtery diseaseBlood pressureCardiac outputHeart rateMental stressGroup IHemodynamic variablesAnger recallGroup IIMental stressorsEnd-systolic ventricular elastanceMental stress-induced changesSemisupine bicycle exerciseGroup II patientsComparable increaseDiastolic blood pressureVentricular ejection fractionExercise-induced changesVascular resistance
1995
Prognostic Implications of Mental Stress-Induced Silent Loft Ventricular Dysfunction in Patients With Stable Angina Pectoris
Jain D, Burg M, Soufer R, Zaret B. Prognostic Implications of Mental Stress-Induced Silent Loft Ventricular Dysfunction in Patients With Stable Angina Pectoris. The American Journal Of Cardiology 1995, 76: 31-35. PMID: 7793399, DOI: 10.1016/s0002-9149(99)80796-6.Peer-Reviewed Original ResearchConceptsStable angina pectorisTransient LV dysfunctionAdverse cardiac eventsCardiac eventsLV dysfunctionAngina pectorisMental stressAbnormal cardiovascular reactivityHigher cardiac eventsCohort of patientsCoronary artery diseaseGroup of patientsVentricular function monitoringMental arithmeticVentricular dysfunctionAdverse eventsBaseline characteristicsBeta blockersContinuous ambulatoryArtery diseaseRisk stratificationPrognostic implicationsStress perfusionFunction monitoringHeart rateEjection fraction fall during mental stress in coronary artery disease: Is it due to peripheral effects or contractile dysfunction?
Shaker S, Jain D, Burg M, Wackers F, Soufer R, Zaret B. Ejection fraction fall during mental stress in coronary artery disease: Is it due to peripheral effects or contractile dysfunction? Journal Of Nuclear Cardiology 1995, 2: s27. DOI: 10.1016/s1071-3581(05)80195-3.Peer-Reviewed Original ResearchPrognostic value of mental stress induced silent left ventricular dysfunction in coronary artery disease
Jain D, Burg M, Soufer R, Zaret B. Prognostic value of mental stress induced silent left ventricular dysfunction in coronary artery disease. Journal Of Nuclear Cardiology 1995, 2: s91. DOI: 10.1016/s1071-3581(05)80449-0.Peer-Reviewed Original Research
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
1991
Silent left ventricular dysfunction during routine structured interview and induced mental stress in stable coronary patients: Impact of type a behavior
Jain D, Burg M, Soufer R, Kerns R, Zaret B. Silent left ventricular dysfunction during routine structured interview and induced mental stress in stable coronary patients: Impact of type a behavior. Journal Of The American College Of Cardiology 1991, 17: a90. DOI: 10.1016/0735-1097(91)91326-a.Peer-Reviewed Original Research