Acute and chronic psychological stress has been shown to be a risk factor for cardiac events. More recently, with the advent of new technology allowing cardiac imaging, acute psychological stressors have been shown to produce myocardial ischemia in certain subsets of patients with coronary artery disease. Several studies have shown that the production of myocardial ischemia in response to acute psychological stress in the laboratory is a marker for adverse events in patients with coronary artery disease. Several pathways by which psychologically induced stress may trigger ischemic events have been proposed and a number of studies have provided evidence that stress effects ischemic events via these pathways. Stress interventions have been shown to have a positive impact on CAD outcomes, with only one thus far testing their effects on psychological stress induced ischemic events. Further, some studies have reported positive results with coronary risk factors using meditation and yoga. Current clinical meditation literature suggests that a mindfulness meditation based stress reduction program (i.e., multicomponent, psychoeducational program based in mindfulness meditation which cultivates an ability to pay attention to one's moment-to- moment experiences in a nonjudgemental, nonreactive fashion) will be able to reduce stress reactivity in CAD patients. It is predicted that such reduction in stress reactivity will result in reduced radionuclide imaged perfusion defects during a laboratory mental stress task. Although it has not been used with heart patients, it has demonstrated good results with both stress and symptomology in the general and other medical populations. We believe that similar results will be seen in CAD patients with effects acting through the following pathways; 1) decreased sympathetic tone, and 2) increased parasympathetic tone. The overall goal of the proposed study is to evaluate the efficacy of a meditation based stress reduction program for the reduction of mental stress induced ischemia.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL072059-02
Application #
6729902
Study Section
Biobehavioral and Behavioral Processes 3 (BBBP)
Program Officer
Kaufmann, Peter G
Project Start
2003-05-01
Project End
2008-04-30
Budget Start
2004-05-01
Budget End
2005-04-30
Support Year
2
Fiscal Year
2004
Total Cost
$431,158
Indirect Cost
Name
University of Florida
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
969663814
City
Gainesville
State
FL
Country
United States
Zip Code
32611
York, Kaki M; Hassan, Mustafa; Sheps, David S (2009) Psychobiology of depression/distress in congestive heart failure. Heart Fail Rev 14:35-50
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Hassan, Mustafa; Mela, April; Li, Qin et al. (2009) The effect of acute psychological stress on QT dispersion in patients with coronary artery disease. Pacing Clin Electrophysiol 32:1178-83
Hassan, Mustafa; Li, Qin; Brumback, Babette et al. (2008) Comparison of peripheral arterial response to mental stress in men versus women with coronary artery disease. Am J Cardiol 102:970-4
Hassan, Mustafa; York, Kaki M; Li, Qin et al. (2008) Variability of myocardial ischemic responses to mental versus exercise or adenosine stress in patients with coronary artery disease. J Nucl Cardiol 15:518-25
Hassan, Mustafa; York, Kaki M; Li, Haihong et al. (2008) Association of beta1-adrenergic receptor genetic polymorphism with mental stress-induced myocardial ischemia in patients with coronary artery disease. Arch Intern Med 168:763-70
York, Kaki M; Hassan, Mustafa; Li, Qin et al. (2007) Do men and women differ on measures of mental stress-induced ischemia? Psychosom Med 69:918-22
Hassan, Mustafa; York, Kaki M; Li, Haihong et al. (2007) Mental stress-induced myocardial ischemia in coronary artery disease patients with left ventricular dysfunction. J Nucl Cardiol 14:308-13
York, Kaki M; Hassan, Mustafa; Li, Qin et al. (2007) Coronary artery disease and depression: patients with more depressive symptoms have lower cardiovascular reactivity during laboratory-induced mental stress. Psychosom Med 69:521-8
Ramachandruni, Srikanth; Fillingim, Roger B; McGorray, Susan P et al. (2006) Mental stress provokes ischemia in coronary artery disease subjects without exercise- or adenosine-induced ischemia. J Am Coll Cardiol 47:987-91

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