Stress and anger may exacerbate heart failure

Date:
August 12, 2020
Source:
Yale University
Summary:
Mental stress and anger may have clinical implications for patients
with heart failure, according to a new report.



FULL STORY ========================================================================== Mental stress and anger may have clinical implications for patients
with heart failure according to a new report published in the Journal
of Cardiac Failure.


========================================================================== Heart failure is a life-threatening cardiovascular disease in which
the heart is damaged or weakened. This can lead to a reduced ejection
fraction, in which the heart muscle pumps out a lower amount of blood
than is typical with each contraction.

In this study of patients who had heart failure with reduced ejection
fraction, the authors -- including researchers at Yale -- evaluated the
effects of stress and anger on diastolic function. Diastolic function
describes the ability of the heart to relax and refill between muscle contractions and is predictive of mortality risk.

For one week, participants completed daily questionnaires about their experiences of stress, anger, and negative emotions during the previous
24 hours. Participants then completed a standardized "mental stress"
protocol in which they solved challenging arithmetic problems and
described a recent stressful experience. Echocardiograms were performed
to assess diastolic function at rest and during the stress task.

Patients who reported experiencing anger in the week prior to the
laboratory mental stress protocol exhibited worse baseline resting
diastolic pressure, the researchers said. Furthermore, most patients demonstrated stress-provoked changes in diastolic function, including
decreased early relaxation and increased diastolic pressure.

"Mental stress is common in patients with heart failure due in
part to the complexities of disease self-management, progressively
worsening functional limitations, and frequent symptom exacerbations and hospitalizations," said the lead author Kristie Harris, a postdoctoral associate in cardiovascular medicine at Yale.

"We have evidence that patients who experience chronically elevated levels
of stress experience a more burdensome disease course with diminished
quality of life and increased risk for adverse events. Clarifying the
relevant behavioral and physiological pathways is especially important
in the era of COVID-19 when the typical stressors of heart failure may
be further compounded by pandemic- related stressors," Harris said.

"Factors such as mental stress and anger often go unrecognized and are
under- addressed," said Matthew Burg, a Yale clinical psychologist and
senior author of the study. "This study contributes to the extensive
literature showing that stress and anger affect clinical outcomes for
patients with heart disease, adding chronic heart failure to the list
that includes ischemic heart disease (narrowed arteries) and arrhythmic disease." Burg said that while stress management and related techniques
have been shown to reduce risk for adverse events among patients with
ischemic heart disease (narrowed arteries), further work is needed to
identify factors that increase vulnerability to the effects of stress
in heart failure, and to determine whether stress management can improve outcomes for these patients.


========================================================================== Story Source: Materials provided by Yale_University. Original written
by Elisabeth Reitman.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Kristie M. Harris, John S. Gottdiener, Stephen S. Gottlieb,
Matthew M.

Burg, Shuying Li, David S. Krantz. Impact of Mental Stress
and Anger on Indices of Diastolic Function in Patients
with Heart Failure. Journal of Cardiac Failure, 2020; DOI:
10.1016/j.cardfail.2020.07.008 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200812144020.htm

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