ArticleCirculation. Cardiovascular imaging2020
Association Between Mental Stress-Induced Inferior Frontal Cortex Activation and Angina in Coronary Artery Disease.
Article in Circulation. Cardiovascular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Mendelian randomization and genetic colocalization infer the effects of the multi-tissue proteome on 211 complex disease-related phenotypes.Genome medicine · 2022Pooled it
- Sex Differences in Psychosocial Factors and Angina in Patients With Chronic Coronary Disease.Journal of the American Heart Association · 2025Trial
- Inter-brain coupling tracks emotional co-regulation.Cognitive, affective & behavioral neuroscience · 2026Article
- The "Brain's Traffic Map" Reveals Neural Pathways Linked to Coronary Microvascular Dysfunction in Women.Brain and behavior · 2026Observational
- Association between marital status and in-hospital mortality in patients with acute coronary syndrome: a multivariable logistic regression analysis.Frontiers in cardiovascular medicine · 2026Article
- Poor Mental Health Status as a Risk Factor and Prognosticator in SMuRF-Less Acute Myocardial Infarction.Journal of clinical medicine · 2025Article
- Multi-Omics Research on Angina Pectoris: A Novel Perspective.Aging and disease · 2024Review
- Stress and cardiovascular disease: an update.Nature reviews. Cardiology · 2024Review
- Central stress pathways in the development of cardiovascular disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Review
- Mental Stress and Cardiovascular Health-Part I.Journal of clinical medicine · 2022Review
- Mental Stress and Its Effects on Vascular Health.Mayo Clinic proceedings · 2022Review
- Cardiovascular pathophysiology from the cardioneural perspective and its clinical applications.Trends in cardiovascular medicine · 2022Review
- Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient.Atherosclerosis · 2021Review
- Neurobiological Pathways Linking Acute Mental Stress to Impairments in Executive Function in Individuals with Coronary Artery Disease.Journal of Alzheimer's disease reports · 2021Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe inferior frontal lobe is an important area of the brain involved in the stress response, and higher activation with acute mental stress may indicate a more severe stress reaction. However, it is unclear if activation of this region with stress correlates with angina in individuals with coronary artery disease.
methodsIndividuals with stable coronary artery disease underwent acute mental stress testing using a series of standardized speech/arithmetic stressors in conjunction with high resolution positron emission tomography imaging of the brain. Blood flow to the inferior frontal lobe was evaluated as a ratio compared with whole brain flow for each scan. Angina was assessed with the Seattle Angina Questionnaire's angina frequency subscale at baseline and 2 years follow-up.
resultsWe analyzed 148 individuals with coronary artery disease (mean age [SD] 62 [8] years; 69% male, and 35.8% Black). For every doubling in the inferior frontal lobe activation, angina frequency was increased by 13.7 units at baseline ([Formula: see text], 13.7 [95% CI, 6.3-21.7];
conclusionsInferior frontal lobe activation with mental stress is independently associated with angina at baseline and during follow-up. Mental stress-induced ischemia and other pain processing brain regions may play a contributory role.
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