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Journal of Nuclear Cardiology
Published in: Journal of Nuclear Cardiology 6/2021

Open Access 01-12-2021 | Anxiety | ORIGINAL ARTICLE

Anxiety and hemodynamic reactivity during cardiac stress testing: The role of gender and age in myocardial ischemia

Authors: Maria T. Bekendam, MSc, Paula M. C. Mommersteeg, PhD, Willem J. Kop, PhD, Jos W. Widdershoven, MD, PhD, Ilse A. C. Vermeltfoort, MD, PhD

Published in: Journal of Nuclear Cardiology | Issue 6/2021

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Abstract

Background

The prevalence of myocardial ischemia is associated with anxiety. State and trait anxiety are more common in younger women compared to men, and high anxiety levels could affect hemodynamic reactivity during cardiac stress testing. The aim is to examine whether anxiety plays a role in gender differences in patients ≤ 65 and > 65 years in hemodynamic reactivity and ischemia during cardiac stress testing.

Methods and results

Included were 291 patients (66.8 ± 8.7 years, 45% women) with suspect ischemia undergoing myocardial perfusion single-photon emission computed tomography (MPI-SPECT). Primary outcomes were semi-quantitative summed difference score (SDS) and summed stress score (SSS), as continuous indicators of myocardial ischemia. Analyses were stratified by age. Trait anxiety was measured using a validated questionnaire (GAD-7) and state anxiety using facial expression analyses software. Overall, trait and state anxiety were not associated with the prevalence of ischemia (N = 107, 36%). A significant interaction was found between gender and trait anxiety in women ≤ 65 years for SDS (F(1,4) = 5.73, P = .019) and SSS (F(1,10) = 6.50, P = .012). This was not found for state anxiety.

Conclusion

SDS and SSS were significantly higher in women younger than 65 years with high trait anxiety. This interaction was not found in men and women over 65 years.
Appendix
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Metadata
Title
Anxiety and hemodynamic reactivity during cardiac stress testing: The role of gender and age in myocardial ischemia
Authors
Maria T. Bekendam, MSc
Paula M. C. Mommersteeg, PhD
Willem J. Kop, PhD
Jos W. Widdershoven, MD, PhD
Ilse A. C. Vermeltfoort, MD, PhD
Publication date
01-12-2021
Publisher
Springer International Publishing
Keyword
Anxiety
Published in
Journal of Nuclear Cardiology / Issue 6/2021
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-020-02079-3

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