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Associations between positive emotional well-being and stress-induced myocardial ischemia: Well-being scores predict exercise-induced ischemia.

Publication ,  Journal Article
Feigal, JP; Boyle, SH; Samad, Z; Velazquez, EJ; Wilson, JL; Becker, RC; Williams, RB; Kuhn, CM; Ortel, TL; Rogers, JG; O'Connor, CM; Jiang, W
Published in: J Psychosom Res
February 2017

OBJECTIVE: Depressive symptoms have been associated with myocardial ischemia induced by mental (MSIMI) and exercise (ESIMI) stress in clinically stable ischemic heart disease (IHD) patients, but the association between positive emotions and inducible ischemia is less well characterized. The objective of this study was to examine the associations between ratings of well-being and stress-induced ischemia. METHODS: Subjects were adult patients with documented IHD underwent mental and exercise stress testing for the Responses of Myocardial Ischemia to Escitalopram Treatment (REMIT) trial. The General Well-Being Schedule (GWBS), with higher scores reflecting greater subjective well-being, and the Center for Epidemiologic Studies Depression Scale (CES-D) were obtained from the REMIT participants. Echocardiography was used to measure ischemic responses to mental stress and Bruce protocol treadmill exercise testing. Data were analyzed using logistic regression adjusting for age, sex, resting left-ventricular ejection fraction (LVEF), and resting wall motion score index, as well as health-related behaviors. RESULTS: GWBS scores were obtained for 210 individuals, with MSIMI present in 92 (43.8%) and ESIMI present in 64 (30.5%). There was a significant inverse correlation between GWBS-PE (Positive Emotion subscale) scores and probability of ESIMI (OR=0.55 (95%CI 0.36-0.83), p=0.005). This association persisted after additional control for CESD subscales measuring negative and positive emotions and for variables reflecting health-related behaviors. A similar inverse correlation between GWBS-PE and MSIMI was observed, but did not reach statistical significance (OR=0.81 (95%CI 0.54-1.20), p=0.28). CONCLUSION: This is, to our knowledge, the first study demonstrating that greater levels of self-reported positive emotions are associated with a lower likelihood of ESIMI among patients with known IHD. Our results highlight the important interface functions of the central nervous and cardiovascular systems and underscore areas for future investigation.

Duke Scholars

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Published In

J Psychosom Res

DOI

EISSN

1879-1360

Publication Date

February 2017

Volume

93

Start / End Page

14 / 18

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Stress, Psychological
  • Statistics as Topic
  • Quality of Life
  • Psychometrics
  • Psychiatry
  • Predictive Value of Tests
  • Myocardial Ischemia
  • Middle Aged
  • Male
 

Citation

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Feigal, J. P., Boyle, S. H., Samad, Z., Velazquez, E. J., Wilson, J. L., Becker, R. C., … Jiang, W. (2017). Associations between positive emotional well-being and stress-induced myocardial ischemia: Well-being scores predict exercise-induced ischemia. J Psychosom Res, 93, 14–18. https://doi.org/10.1016/j.jpsychores.2016.11.012
Feigal, Jacob P., Stephen H. Boyle, Zainab Samad, Eric J. Velazquez, Jennifer L. Wilson, Richard C. Becker, Redford B. Williams, et al. “Associations between positive emotional well-being and stress-induced myocardial ischemia: Well-being scores predict exercise-induced ischemia.J Psychosom Res 93 (February 2017): 14–18. https://doi.org/10.1016/j.jpsychores.2016.11.012.
Feigal JP, Boyle SH, Samad Z, Velazquez EJ, Wilson JL, Becker RC, et al. Associations between positive emotional well-being and stress-induced myocardial ischemia: Well-being scores predict exercise-induced ischemia. J Psychosom Res. 2017 Feb;93:14–8.
Feigal, Jacob P., et al. “Associations between positive emotional well-being and stress-induced myocardial ischemia: Well-being scores predict exercise-induced ischemia.J Psychosom Res, vol. 93, Feb. 2017, pp. 14–18. Pubmed, doi:10.1016/j.jpsychores.2016.11.012.
Feigal JP, Boyle SH, Samad Z, Velazquez EJ, Wilson JL, Becker RC, Williams RB, Kuhn CM, Ortel TL, Rogers JG, O’Connor CM, Jiang W. Associations between positive emotional well-being and stress-induced myocardial ischemia: Well-being scores predict exercise-induced ischemia. J Psychosom Res. 2017 Feb;93:14–18.
Journal cover image

Published In

J Psychosom Res

DOI

EISSN

1879-1360

Publication Date

February 2017

Volume

93

Start / End Page

14 / 18

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Stress, Psychological
  • Statistics as Topic
  • Quality of Life
  • Psychometrics
  • Psychiatry
  • Predictive Value of Tests
  • Myocardial Ischemia
  • Middle Aged
  • Male