Psychophysiological Investigation of Myocardial
Ischemia (PIMI)
Objectives:
To invesitigate psychophysiological factors related to
both symptomatic and asymptomatic cardiac ischemia.
Background:
An important hypothesis has been generated from
current research in this area: manifestations and expressons of cardiac
ischemia are influenced by specified psychophysiological mechanisms.
Subjects:
The study population consisted of 196 patients
recruited from four clinical units all of which were clinical units for the
Asymptomatic Cardiac Ischemia Pilot (ACIP). Patients
eligible for PIMI were identified throughout the screening process established
for the enrollment patients in ACIP.
Design:
The primary goal of PIMI was to test the hypothesis,
"Manifestations and expressions of cardiac ischemia are influenced by specific
psychophysiological mechanisms." The specific relationship to be investigated
were:
- Patients who are susceptible to mental stress
ischemia (indexed by new left ventricular wall motion abnormalities) would
display more ischemia during daily activities and would have ambulatory
ischemia at lower heart rate and activity level thresholds than patients who
are not susceptible.
- Cardiovascular and catecholamine reactivity to
mental stress would be a predictive of severity of mental stress ischemia and
of ambulatory ischemia.
- B-edorphin responses to mental stress and to
exercise would be predictive of asymptomatic ischemia.
- Patients with systematic ischemia and those with
asymptomatic ischemia would show differences in each of the following at rest
and after response to stresses (Exercise and/or mental tests).
- Mental stress would produce different hormonal and
perceptual responses than exercise.
- Asymptomatic Ischemia would be associated with a
lesser severity of ischemia than symptomatic ischemia.
- The location of the ischemic myocardium would be
inferior in a higher proportion of patients with asymptomatic ischemia than of
patients with symptomatic ischemia.
- The latency internal that would be the onset of ST
segment depression and the onset of ischemic pain would be related to somatic
sensory perception, autonomic nervous system reflux control of the heart,
B-endorphin responses, and psychosocial characteristics.
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Study Website |
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Study Documentation |
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Data Distribution Agreement |
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