The overall goal of Project 1 is to examine the prognostic significance of mental stress-induced ischemia in a large and contemporary population of CAD patients with and without exercise-induced ischemia, and to examine the role of genetic variations in the a- and ^ff-adrenergic receptor genes and other gene systems known to regulate the reactivity response to stress. Specifically, we propose to address the following aims:
Aim 1 : Among CAD patients with and without exercise-induced ischemia, examine the relationship between mental stress-induced ischemia and adverse outcomes defined as: a) death and myocardial infarction (Ml); and b) a composite index of death, nonfatal Ml, hospitalization for unstable angina, and need for revascularization (coronary bypass surgery or percutaneous intervention). We will test the hypothesis that CAD patients with mental stress-induced ischemia will have higher rates of adverse outcomes than those without mental stress-induced ischemia irrespective of the presence of exercise-induced ischemia.
Aim 2 : Among CAD patients with and without exercise-induced ischemia, examine the relationship between genetic polymorphisms of the a- and;ff-adrenergic receptors and other candidate genes related to the stress response and mental stress-induced ischemia. We will test the hypothesis that these genetic polymorphisms will be associated with mental stress-induced ischemia and thus the allele and/or genotype frequencies in CAD patients without mental stress-induced ischemia will differ from those in patients with mental stress-induced ischemia.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Program Projects (P01)
Project #
5P01HL101398-03
Application #
8379960
Study Section
Special Emphasis Panel (ZHL1-PPG-Z)
Project Start
Project End
Budget Start
2012-12-01
Budget End
2013-11-30
Support Year
3
Fiscal Year
2013
Total Cost
$653,383
Indirect Cost
$231,847
Name
Emory University
Department
Type
DUNS #
066469933
City
Atlanta
State
GA
Country
United States
Zip Code
30322
Vaccarino, Viola; Shah, Amit J; Rooks, Cherie et al. (2014) Sex differences in mental stress-induced myocardial ischemia in young survivors of an acute myocardial infarction. Psychosom Med 76:171-80
Corban, Michel T; Hung, Olivia Y; Eshtehardi, Parham et al. (2014) Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. J Am Coll Cardiol 63:2346-55
Wei, Jingkai; Rooks, Cherie; Ramadan, Ronnie et al. (2014) Meta-analysis of mental stress-induced myocardial ischemia and subsequent cardiac events in patients with coronary artery disease. Am J Cardiol 114:187-92
Kulshreshtha, Ambar; Zheng, Yan; Quyyumi, Arshed A et al. (2014) Endothelial Dysfunction is Associated with Occult Coronary Artery Disease Detected by Positron Emission Tomography. IJC Metab Endocr 4:28-32
Shah, Amit J; Ghasemzadeh, Nima; Zaragoza-Macias, Elisa et al. (2014) Sex and age differences in the association of depression with obstructive coronary artery disease and adverse cardiovascular events. J Am Heart Assoc 3:e000741
Ramadan, Ronnie; Vaccarino, Viola; Esteves, Fabio et al. (2014) Association of vitamin D status with mental stress-induced myocardial ischemia in patients with coronary artery disease. Psychosom Med 76:569-75
Wei, Jingkai; Pimple, Pratik; Shah, Amit J et al. (2014) Depressive symptoms are associated with mental stress-induced myocardial ischemia after acute myocardial infarction. PLoS One 9:e102986
Vaccarino, Viola; Bremner, J Douglas (2013) Traumatic stress is heartbreaking. Biol Psychiatry 74:790-2
Ramadan, Ronnie; Sheps, David; Esteves, Fabio et al. (2013) Myocardial ischemia during mental stress: role of coronary artery disease burden and vasomotion. J Am Heart Assoc 2:e000321
Samady, Habib; Hung, Olivia Y (2013) Coronary microvasculature: small vessels with large impact. Circ Cardiovasc Interv 6:323-5