Effects Of Mental Stress On Autonomic Nervous Function In Patients With Non-obstructive Angina

Background: The incidence rate of Angina with non-obstructive coronary artery disease(ANOCA)is high.Studies show that in women with angina pectoris,the proportion of patients with ANOCA is over 2/3.Psychological factors are important influencing factors of ANOCA.Negative mental health has a negative impact on the prognosis of cardiovascular disease.Autonomic nervous system is an important bridge between mind and heart.To explore the potential mechanism of mental stress on the autonomic nervous system of patients with ANOCA is helpful to provide new ideas for the identification,diagnosis and treatment of patients with ANOCA.Objective: To explore the differences and similarities of autonomic nervous function and hemodynamic dynamic change pattern between patients with ANOCA and healthy control group when facing mental stress.Methods: ANOCA patients(female angina pectoris patients with coronary artery stenosis< 50%)in Department of Cardiology of Guangdong Provincial People’s hospital were selected as the research objects(n = 76),and age-matched healthy people without angina pectoris were recruited as the control group(n = 30).Life event scale(LES),perceived stress Scale-14(pss-14)and hospital anxiety and Depression Scale(HADS)were used to record the subjects’ stress,depression and anxiety levels,and self-made general information questionnaire was used to understand the patients’ sleep,exercise and other information.Baseline blood parameters were collected.In the process of mental stress(MS)test,hemodynamics,heart rate variability(HRV)and other indicators were continuously detected,and the self-perceived stress score of the subjects was evaluated after the stress test.Statistical comparison and related factor analysis were performed at different time points and between groups.Results: In ANOCA population,the proportion of patients who are not satisfied with sleep quality is significantly higher than that of healthy control group.The influence of negative life events and the degree of conscious stress in ANOCA patients were significantly higher than those in the control group.The patients with higher influence of negative life events had higher degree of conscious stress.In the face of psychological stress,the change of systolic blood pressure in ANOCA patients was mainly,and the recovery rate was significantly lower than that in the control group.When ANOCA patients deal with psychological stress,their autonomic nervous response has decreased physiological flexibility,which is characterized by slow recovery.The higher the score of LES negative events or the higher the total score of PSS,the weaker the physiological flexibility of patients in coping with psychological stress.Conclusion: ANOCA patients’ physiological flexibility decreased under mental stress,and the most significant difference was in the range of autonomic nervous response during recovery,which was closely related to the degree of conscious stress and the score of negative life events.