Hyperventilation as Diagnostic Stress Test for Variant Angina and Cardiomyopathy: Cardiovascular Responses, Likely Triggering Mechanisms and Psychophysiological Implications

Background. Adults born extremely preterm appear to have more difficulty managing the stresses of early adulthood than their term-born peers. Objective. To examine the effects of being born at extremely low birth weight (ELBW; birth weight < 1000 g) versus at full term on cardiovascular responses to stress. Method. Cardiovascular responses were elicited during administration of a widely used laboratory stressor, the Trier Social Stress Test (TSST). Results. Term-born adults exhibited a larger decrease in total peripheral resistance and larger increase in cardiac output for TSST performance, reflecting greater resilience, than did ELBW adults. Furthermore, in ELBW participants but not controls, cardiovascular responses were correlated with anxiety, suggesting that their responses reflected feelings of stress. Conclusions. Skills-training and practice with relevant stressors may be necessary to increase the personal resources of ELBW participants for managing stress as they transition to adulthood.

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VARIANT ANGINA

The Professional Medical Journal ◽

10.29309/tpmj/2006.13.02.5023 ◽

2006 ◽

Vol 13 (02) ◽

pp. 259-263

Author(s):

MUHAMMAD SHAH GILANI ◽

Qaiser Mahmood ◽

SHAH NAWAZ HASSAN GARDEZI ◽

Abrar Ahmad Khan ◽

ABDUL SATTAR ◽

...

Keyword(s):

Clinical Features ◽

Stress Test ◽

Sampling Technique ◽

Coronary Arteriography ◽

Variant Angina ◽

Group I ◽

Exertional Angina ◽

History Of ◽

Artery Disease ◽

Coronary Arterydisease

Introduction: The syndrome of variant angina occurs in patients with awide spectrum of coronary artery obstructions, ranging from normal coronary arteries to severe 3-vessel coronary arterydisease (CAD). Treatment of these patients is, in large part, determined by the extent and severity of the underlyingfixed coronary obstructions. Objective: To determine the clinical features of variant angina with and without fixed severecoronary artery disease. Setting: Nishtar Hospital, Multan. Duration: Two years. Study design: Descriptive,comparative analytical study. Material & methods: Sample size 108 patients. Sampling technique: Convenientprobability sampling done. Results: 43 patients with variant angina who had less than 50% fixed coronary luminaldiameter narrowing (group-I) were compared with 65 patients with variant angina who had 70% or greater diameternarrowing (group-II). Statistically significant differences were found in 3 clinical features between group-I and group-IIi.e. (1) a more than 3 months history of angina at rest before diagnosis (80% vs 23%, P <0.001); (2) an abnormalelectrocardiogram at rest (19 vs 48%, P <0.01). (3) an abnormal stress test (26% (8 of 30) vs 84% (15 of 18), P <0.01.However, these features were not clinically reliable in separating patients with variant angina with and without fixedsevere obstructions because of overlap between the two groups. No difference was found between the 2 groups in age,sex, predominant symptoms at the time of catheterization, history of exertional angina, syncope with angina, prolongedangina, previous artery disease. Conclusion: Coronary arteriography should be performed to define the underlyingcoronary anatomy and to determine optimal therapy in patients with variant angina.

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An Online Trier Social Stress Paradigm to Evoke Affective and Cardiovascular Responses

10.31234/osf.io/fcyqd ◽

2021 ◽

Author(s):

Caitlin Marie DuPont ◽

Sarah Pressman ◽

Rebecca G Reed ◽

Anna Marsland ◽

Stephen N. Manuck ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Social Stress ◽

Stress Condition ◽

Mental Arithmetic ◽

Stress Test ◽

Area Under The Curve ◽

Cardiovascular Responses ◽

Trier Social Stress Test ◽

Good Test

In response to the COVID-19 pandemic, prior studies have modified the Trier Social Stress Test to be conducted remotely. The current report aimed to extend these studies to test whether a remote Trier Social Stress Test (rTSST) can elicit (a) affective, (b) blood pressure, and (c) heart rate responses relative to a control condition and whether these responses were reliable when assessed one week later. Participants (N = 99, 19.7 ± 3.5 years, 55% female) were randomized to a control or stress condition. Controls completed easier versions of the tasks with a single, friendly researcher. Stress participants performed more difficult versions of the task in front of two judges who participants believed were rating their performance. Blood pressure and heart rate were measured every two minutes throughout, while affect was assessed at baseline, after the final task, and following recovery. The rTSST was feasible to administer with minimal technical issues reported. Results suggest that lower positive affect and higher negative affect were reported during the tasks in the stress condition relative to controls. Similarly, stress participants had higher cardiovascular responses during the tasks relative to controls, except that blood pressure was not elevated during mental arithmetic in stress participants relative to controls. Cardiovascular responses demonstrated good test-retest reliability when assessed one week later, especially when computed using area under the curve methods. Overall, a rTSST can be used to elicit affective and cardiovascular reactivity and provides an opportunity to include participants previously unreachable for in-person laboratory procedures.

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Abstract P249: Melanocortin-4 Receptors in Cholinergic Preganglionic Neurons of the Hindbrain and Spinal Cord are Important in Mediating Cardiovascular Responses to Acute Stress

Hypertension ◽

10.1161/hyp.68.suppl_1.p249 ◽

2016 ◽

Vol 68 (suppl_1) ◽

Author(s):

Jussara M do Carmo ◽

Taoling Fang ◽

Sydney P Moak ◽

Jackson R Browing ◽

John E Hall

Keyword(s):

Spinal Cord ◽

Acute Stress ◽

Nucleus Tractus Solitarius ◽

Stress Test ◽

Recovery Period ◽

Cardiovascular Responses ◽

Preganglionic Neurons ◽

Air Jet ◽

Melanocortin 4 Receptor ◽

The Impact

Previous studies suggest that melanocortin-4 receptor (MC4R) activation in areas outside of the hypothalamus may regulate appetite but the role of MC4R in specific neuronal populations of the hindbrain in regulating cardiovascular function are still unknown. We examined the impact of total body MC4R deficiency (LoxTB-MC4R mice) and restoration of MC4R specifically in the brainstem and/or spinal cord on blood pressure (BP) response to acute stress. We selectively rescued MC4R only in preganglionic parasympathetic neurons of the dorsal motor of the vagus (DMV) and in the nucleus tractus solitarius (NTS) (LoxTB-MC4R/Phox2B-cre mice, n=5) or in cholinergic preganglionic neurons of the hindbrain and spinal cord (LoxTB-MC4R/Chat-cre mice, n=4). Mice were implanted with telemetry probes for measurement of mean arterial pressure (MAP) and heart rate (HR). After a 10-day recovery period, MAP and HR were continuously measured for 30 minutes before, during and 30 minutes after an air jet stress test. Acute air jet stress significantly increased MAP by 33±3 in WT mice and 31±2 in LoxTB-MC4R/Chat-cre mice compared to only 18±4 or 20±3 mmHg in LoxTB-MC4R/Phox2B-cre mice and LoxTB-MC4R mice, respectively. HR was increased by 180±20, 110±20, 100±23, and 127±15 bpm in response to air jet stress in WT, LoxTB-MC4R, LoxTB-MC4R/Phox2B and LoxTB-MC4R/Chat-cre mice, respectively. These results indicate that MC4Rs in cholinergic preganglionic neurons of the hindbrain and spinal cord play a key role in the BP responses to acute stress. (NHLBI-PO1HL51971, NIGMS- P20GM104357, and AHA-SDG5680016)

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Haemodynamic changes in man during immersion in water at different temperatures

Clinical Science ◽

10.1042/cs0730613 ◽

1987 ◽

Vol 73 (6) ◽

pp. 613-616 ◽

Cited By ~ 46

Author(s):

C. F. M. Weston ◽

J. P. O'Hare ◽

J. M. Evans ◽

R. J. M. Corrall

Keyword(s):

Cardiac Output ◽

Stroke Volume ◽

Stress Test ◽

Peripheral Resistance ◽

Cardiovascular Responses ◽

Normal Subjects ◽

Ultrasound Technique ◽

Haemodynamic Changes ◽

Different Temperatures ◽

Increasing Temperature

1. Stroke volume and cardiac output were measured using the Doppler ultrasound technique in 16 normal subjects immersed to the neck in water at 33°C, 35°C, 37°C and 39°C. A standard aortic diameter was assumed and results were expressed as percentage changes from pre-immersion resting values. 2. Cardiac output rose progressively at higher temperatures, increasing by 30% at 33°C and by 121% at 39°C. At thermoneutral temperatures (33°C and 35°C) this was achieved by an increase in stroke volume of 50% despite a significant decrease in heart rate. There was a further rise in stroke volume and pulse rate at higher temperatures and a mean tachycardia of 109 ± 4 beats/min was noted at 39°C. Calculated peripheral resistance reduced progressively with increasing temperature of immersion. 3. This non-invasive and simple technique may provide a non-exercise-related cardiovascular stress test to study cardiovascular responses in a variety of pathophysiological states.

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The ergonovine stress test: A provocative test for diffuse esophageal spasm or variant angina?

The American Journal of Cardiology ◽

10.1016/0002-9149(80)90868-1 ◽

1980 ◽

Vol 45 (2) ◽

pp. 440 ◽

Cited By ~ 3

Author(s):

Kenneth L. Koch ◽

Ann Long ◽

R.Charles Curry ◽

John R. Mathias

Keyword(s):

Stress Test ◽

Diffuse Esophageal Spasm ◽

Variant Angina ◽

Provocative Test ◽

Esophageal Spasm

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Maternal B12, Folate and Homocysteine Concentrations and Offspring Cortisol and Cardiovascular Responses to Stress

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz114 ◽

2020 ◽

Vol 105 (7) ◽

pp. e2591-e2599

Author(s):

Ghattu V Krishnaveni ◽

Sargoor R Veena ◽

Matt Johnson ◽

Kalyanaraman Kumaran ◽

Alexander Jones ◽

...

Keyword(s):

Heart Rate ◽

Vitamin B12 ◽

Stress Responses ◽

Total Peripheral Resistance ◽

Mental Arithmetic ◽

Stress Test ◽

Peripheral Resistance ◽

Cardiovascular Responses ◽

Trier Social Stress Test ◽

Plasma Vitamin

Abstract Context Imbalances in maternal 1-carbon nutrients (vitamin B12, folate) have been shown to be associated with higher offspring cardiometabolic risk markers in India. Objective We examined the hypothesis that low plasma vitamin B12 (B12) and high folate and homocysteine concentrations in the mother are associated with higher hypothalamic–pituitary–adrenal axis (cortisol) and cardiovascular responses during the Trier Social Stress Test for Children (TSST-C) in an Indian birth cohort. Methods Adolescents (n = 264; mean age: 13.6 years), whose mothers’ plasma B12, folate and total homocysteine concentrations had been measured during pregnancy, completed 5-minutes each of public speaking and mental arithmetic tasks in front of 2 unfamiliar “judges” (TSST-C). Baseline and poststress salivary cortisol concentrations were measured. Heart rate, blood pressure, stroke volume, cardiac output, and total peripheral resistance were measured continuously at baseline, during the TSST-C, and for 10 minutes after the TSST-C using a finger cuff; beat-to-beat values were averaged for these periods, respectively. Results Maternal low B12 status (plasma B12 < 150 pmol/L) was associated with greater cortisol responses to stress in the offspring (P < .001). Higher homocysteine concentrations were associated with greater offspring heart rate response (P < .001). After adjustment for multiple comparisons, there were nonsignificant associations between higher maternal folate concentrations and offspring total peripheral resistance response (P = .01). Conclusion Our findings suggest that maternal 1-carbon nutritional status may have long-term programming implications for offspring neuroendocrine stress responses.

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