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Detailed assessment of the hemodynamic response to psychosocial stress using real-time MRI
Journal of Cardiovascular Magnetic Resonance volume 13, Article number: P68 (2011)
Mental stress is a potent stimulator of the cardiovascular system and has been linked to a number of cardiovascular diseases. Characterization of the cardiovascular response to mental stress is crucial for understanding the underlying mechanisms. Previous studies have relied upon unreliable stress paradigms and limited cardiovascular parameters, with mixed results. An experimental method that causes stress reliably and allows accurate and detailed measurement of cardiovascular physiology during it, holds the promise to significantly further understanding of the emerging links between stress and cardiovascular disease.
To demonstrate that combining the Montreal Imaging Stress Task (MIST) with real-time cardiac MR allows detailed assessment of the cardiovascular mental stress response.
22 healthy volunteers (1:1 M:F, 26-64 years) underwent MR imaging during rest and the MIST. Real-time spiral phase contrast MR, accelerated with sensitivity encoding (SENSE) was used to assess stroke volume (SV) and radial k-t SENSE was used to assess ventricular volumes. Simultaneous heart rate (HR) and blood pressure (BP) measures allowed calculation of cardiac output (CO), systemic vascular resistance (SVR) and arterial compliance (TAC). Endocrine responses were assessed using salivary cortisol.
In response to stress, BP increased due to increased CO and reduced TAC but not increased SVR, which fell (see Figure). HR, not SV, determined CO increases. Men had greater BP during stress (130 vs 118 mmHg; P=.04) due to greater CO increases and relatively higher SVR. Older participants had greater BP responses (r=.47, P=.03) due to greater falls in TAC (r=-.45, P=.04). Greater cortisol response was correlated with greater falls in TAC (r=-.59, P=.006) but resting cortisol and TAC were not related (r=-.32, P=.17).
This new approach allows detailed, accurate and reliable assessment of stress physiology. Preliminary findings suggest stress exposes relationships, not seen at rest, of cardiovascular function with age, sex and endocrine function.
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Jones, A., Steeden, J.A., Pruessner, J.C. et al. Detailed assessment of the hemodynamic response to psychosocial stress using real-time MRI. J Cardiovasc Magn Reson 13, P68 (2011). https://doi.org/10.1186/1532-429X-13-S1-P68
- Cardiac Output
- Stroke Volume
- Systemic Vascular Resistance
- Mental Stress