iScience (Dec 2024)
Myocardial blood flow mechanism of mental stress-induced myocardial ischemia in women with ANOCA
- Han Yin,
- Fengyao Liu,
- Bingqing Bai,
- Quanjun Liu,
- Yuting Liu,
- Haochen Wang,
- Yu Wang,
- Yannis Yan Liang,
- Anbang Liu,
- Xueju Yu,
- Cheng Jiang,
- Chao Wu,
- Bo Kong,
- Jingjin Liu,
- Lan Guo,
- Hongwen Fei,
- Shuxia Wang,
- Wei Jiang,
- Huan Ma,
- Qingshan Geng
Affiliations
- Han Yin
- The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China; Department of Geriatrics, Shenzhen Clinical Research Centre for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University. The First Affiliated Hospital, School of Medicine, Southern University of Science and Technology), Shenzhen, China
- Fengyao Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; School of Medicine, South China University of Technology, Guangzhou, China
- Bingqing Bai
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou, Guangdong, China
- Quanjun Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; School of Medicine, South China University of Technology, Guangzhou, China
- Yuting Liu
- The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China; Department of Geriatrics, Shenzhen Clinical Research Centre for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University. The First Affiliated Hospital, School of Medicine, Southern University of Science and Technology), Shenzhen, China
- Haochen Wang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Yu Wang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Yannis Yan Liang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Anbang Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; School of Medicine, South China University of Technology, Guangzhou, China
- Xueju Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Cheng Jiang
- The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China; Department of Geriatrics, Shenzhen Clinical Research Centre for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University. The First Affiliated Hospital, School of Medicine, Southern University of Science and Technology), Shenzhen, China
- Chao Wu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Bo Kong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; School of Medicine, South China University of Technology, Guangzhou, China
- Jingjin Liu
- The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China; Department of Geriatrics, Shenzhen Clinical Research Centre for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University. The First Affiliated Hospital, School of Medicine, Southern University of Science and Technology), Shenzhen, China
- Lan Guo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Hongwen Fei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Shuxia Wang
- Department of Nuclear Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Corresponding author
- Wei Jiang
- Department of Internal Medicine, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Corresponding author
- Huan Ma
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Corresponding author
- Qingshan Geng
- The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China; Department of Geriatrics, Shenzhen Clinical Research Centre for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University. The First Affiliated Hospital, School of Medicine, Southern University of Science and Technology), Shenzhen, China; Corresponding author
- Journal volume & issue
-
Vol. 27,
no. 12
p. 111302
Abstract
Summary: Mental stress-induced myocardial ischemia (MSIMI) is linked to a 2-fold increase in cardiovascular events, but its underlying myocardial blood flow (MBF) mechanisms remain underexplored. Using nitrogen-13-ammonia cardiac positron emission tomography-computed tomography (PET-CT) assessing myocardial perfusion defect and MBF under resting, mental stress (MS), adenosine stress (AS) conditions, angina with no obstructive coronary artery disease (ANOCA) women showed a significantly higher prevalence of MSIMI compared to age-matched healthy controls (36/84 vs. 1/42, p < 0.001). The MBFAS and rate-pressure product-corrected MBFMS were consistently lower, especially in the left anterior descending artery territory, in participants with increased perfusion defect scores under MS. The lowest values of restricted coronary flow reserve and corrected MBFMS in participants of ANOCA&MSIMI+ group indicated that impaired coronary microvascular function and mismatch between myocardial blood supply and demand together constitute the pathogenic mechanism of MSIMI in ANOCA population. These findings deepen our understanding of the pathophysiological mechanisms of MSIMI and confirm the long-standing hypothesis of the involvement of impaired coronary microvascular function.
