Fatigue and Cardiovascular Response during Mental Stress Challenge in Coronary Artery Disease Patients after Acute Coronary Syndrome

Background. Fatigue and psychophysiological reactions to mental stress are known to be problematic in coronary artery disease (CAD) patients. Currently, studies exploring the relationship between fatigue and cardiovascular reactivity to stress are scarce and inconsistent. The current study aimed to investigate the links between cardiovascular response to mental stress and fatigue in CAD patients after acute coronary syndrome (ACS). Methods. The cross-sectional study investigated 142 CAD patients (85% male, 52±8 years) after ACS. Fatigue symptoms were measured using Multidimensional Fatigue Inventory 20-items, while cardiovascular stress reactivity (i.e. change in systolic [s] and diastolic [d] blood pressure [ΔBP], and heart rate [ΔHR]) was evaluated during Trier Social Stress Test (TSST). In addition, participants completed Hospital Anxiety and Depression scale, Type D Scale-14, Mini-Mental State Examination, and Visual Analog Scale. Multivariable linear regression analyses were...Show moreBackground. Fatigue and psychophysiological reactions to mental stress are known to be problematic in coronary artery disease (CAD) patients. Currently, studies exploring the relationship between fatigue and cardiovascular reactivity to stress are scarce and inconsistent. The current study aimed to investigate the links between cardiovascular response to mental stress and fatigue in CAD patients after acute coronary syndrome (ACS). Methods. The cross-sectional study investigated 142 CAD patients (85% male, 52±8 years) after ACS. Fatigue symptoms were measured using Multidimensional Fatigue Inventory 20-items, while cardiovascular stress reactivity (i.e. change in systolic [s] and diastolic [d] blood pressure [ΔBP], and heart rate [ΔHR]) was evaluated during Trier Social Stress Test (TSST). In addition, participants completed Hospital Anxiety and Depression scale, Type D Scale-14, Mini-Mental State Examination, and Visual Analog Scale. Multivariable linear regression analyses were completed to evaluate associations between fatigue and cardiovascular response to TSST, while controlling for confounders. Results. After controlling for baseline levels of cardiovascular measures, age, gender, education, New York Heart Association functional class, arterial hypertension, smoking history, use of nitrates, anxiety and depressive symptoms, Type D Personality, perceived difficulty and efforts, the cardiovascular reactivity to anticipatory stress remained significantly linked with global fatigue (ΔHR: β=-0.238; p=0.04), mental fatigue (ΔsBP: β=-0.244; p=0.04; ΔHR β=-0.303; p=0.01) and total fatigue score (ΔsBP: β=-0.331; p=0.01; ΔHR: β=-0.324; p=0.01). Conclusions: In CAD patients after ACS, fatigue was associated with diminished anticipatory stress during mental stress challenge, even after inclusion of possible confounders. Further similar studies exploring other psychophysiological stress responses are warranted.Show less

Leiden University Student Repository

Documents

In Collections

Fatigue and Cardiovascular Response during Mental Stress Challenge in Coronary Artery Disease Patients after Acute Coronary Syndrome