Validation and Quantification of Mental Stress Tests, and their Application to Acute Cardiovascular Patients

In children, we studied noninvasively the cardiovascular stress responses, including changes over time of systolic blood pressure (SBP), heart rate (HR), and stroke volume (SV) in isometric handgrip (IHG) and mental arithmetic. Specifically, we asked whether 1) these cardiovascular stress responses were different for the two stress conditions in children, 2) these responses differed in boys and girls, and 3) the anthropometric variables related to these stress responses. SV differed significantly between IHG and mental arithmetic over the entire stress period. This may reflect higher systemic vascular resistance during IHG. HR in boys was lower than in girls over the entire period of stress in both stress tests. This observation cannot be attributed to differences in conditioning, because this should not influence responses to isometric or mental stress. A larger left ventricular mass was related to higher SVs. A marked relationship was found between HR and SBP and between HR and SV. No relationship was found between SBP and SV.

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Cardiac function during mental stress: cholinergic modulation with pyridostigmine in healthy subjects

Clinical Science ◽

10.1042/cs20030064 ◽

2003 ◽

Vol 105 (2) ◽

pp. 161-165 ◽

Cited By ~ 23

Author(s):

Isis Délio SANT'ANNA ◽

Eduardo Branco DE SOUSA ◽

Alvaro Villela DE MORAES ◽

Débora Lopes LOURES ◽

Evandro Tinoco MESQUITA ◽

...

Keyword(s):

Oral Administration ◽

Mental Stress ◽

Healthy Subjects ◽

Mental Arithmetic ◽

Systolic Pressure ◽

Left Ventricular Diastolic Function ◽

Left Ventricular ◽

Stress Tests ◽

Mean Velocity ◽

Double Blind

Mentally or emotionally stressful situations occur throughout our lives and cause physiological haemodynamic responses. In patients with coronary artery disease, such events can also induce myocardial ischaemia and ventricular arrhythmias, increasing mortality rates. The purpose of the present study was to determine the acute effects of the oral administration of pyridostigmine, a reversible cholinesterase inhibitor and thus an indirect cholinomimetic drug, on echocardiographic variables during mental stress in healthy subjects. A total of 18 healthy young volunteers were subjected to mental stress tests (mental arithmetic and the Stroop colour–word test) 2 h after the oral administration of either placebo or pyridostigmine bromide (45 mg), using a balanced-randomized, double-blind, crossover protocol. During mental stress, heart rate (pyridostigmine, 64±1 beats/min; placebo, 70±1 beats/min; P=0.0003) and diastolic blood pressure (pyridostigmine, 66±2 mmHg; placebo, 79±3 mmHg; P=0.01) were lower in the pyridostigmine group, but systolic pressure was not (pyridostigmine, 124±3 mmHg; placebo, 123±3 mmHg; P=0.40). There were no detectable abnormalities in the left ventricular wall motion score during mental stress, but left ventricular outflow tract mean velocity (pyridostigmine, 0.68±0.02 m/s; placebo, 0.64±0.02 m/s; P<0.05) and mitral inflow velocity deceleration (placebo, 4.05±0.18 m/s2; pyridostigmine, 4.41±0.16 m/s2; P<0.05) were higher in the pyridostigmine group. In conclusion, cholinergic stimulation with pyridostigmine seems to increase left ventricular diastolic function during mental stress in healthy subjects.

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