ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2023
Quantitation of diffuse myocardial ischemia with mental stress and its association with cardiovascular events in individuals with recent myocardial infarction.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Heightened Risk of Myocardial Ischemia With Mental Stress Among Black Women Survivors of a Myocardial Infarction in Midlife.Journal of the American Heart Association · 2026Article
- Real-life Psychological Experiences and Cardiac Autonomic Physiology among Survivors of a Myocardial Infarction in Midlife.Research square · 2025Article
- Stress and cardiovascular disease: an update.Nature reviews. Cardiology · 2024Review
- The Role of Psychosocial Stress on Cardiovascular Disease in Women: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2024Review
- Heart-brain axis: Pushing the boundaries of cardiovascular molecular imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2024Review
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Authors and funding
15 authors at 4 institutions in 2 countries.
Funding
Abstract
Microcirculatory dysfunction during psychological stress may lead to diffuse myocardial ischemia. We developed a novel quantification method for diffuse ischemia during mental stress (dMSI) and examined its relationship with outcomes after a myocardial infarction (MI). We studied 300 patients ≤ 61 years of age (50% women) with a recent MI. Patients underwent myocardial perfusion imaging with mental stress and were followed for 5 years. dMSI was quantified from cumulative count distributions of rest and stress perfusion. Focal ischemia was defined in a conventional fashion. The main outcome was a composite outcome of recurrent MI, heart failure hospitalizations, and cardiovascular death. A dMSI increment of 1 standard deviation was associated with a 40% higher risk for adverse events (HR 1.4, 95% CI 1.2-1.5). Results were similar after adjustment for viability, demographic and clinical factors and focal ischemia. In sex-specific analysis, higher levels of dMSI (per standard deviation increment) were associated with 53% higher risk of adverse events in women (HR 1.5, 95% CI 1.2-2.0) but not in men (HR 0.9, 95% CI 0.5-1.4), P 0.001. A novel index of diffuse ischemia with mental stress was associated with recurrent events in women but not in men after MI.
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