Correlation of Stress-Mediated Peripheral Blood Neurotransmitter Changes with the Progression of Coronary Artery Tortuosity
Objective To investigate the correlation between stress-mediated peripheral blood neurotransmitter changes and the progression of coronary artery tortuosity(CAT).Methods A total of 465 CAT pre-treatment patients admitted to the Department of Cardiology of Fuwai Central China Cardiovascular Hospital from January to December 2018 were included as study subjects,and the subjects were divided into a group without anxiety and depressive symptoms(275 cases)and a group with anxiety and depressive symptoms(190 cases)based on the scores of Chinese perceived stress scale(CPSS)and the Hamilton anxiety scale(HAMA).The general data of the patients were collected,and the depression status was evaluated using the CPSS and HAMA scales and the type C personality behavioral patterns questionnaire,the peripheral blood neurotransmitters[norepinephrine(NE),epinephrine(E),dopamine(DA),gamma-aminobutyric acid(GABA),5-hydroxytryptamine(5-HT),and glutamate(Glu)]and C-reactive protein(CRP)levels were measured by enzyme-linked immunosorbent assay.The incidence of coronary atherosclerosis(AS)and the occurrence time were counted in patients at follow-up.Correlation analysis of CPSS and HAMA scores with type C personality behavioral patterns was performed by Pearson's method,and logistic regression analysis was used to explore the factors influencing the occurrence of endpoint events in CAT patients.Results Compared with the group without anxiety and depressive symptoms,patients in the group with anxiety and depressive symptoms had higher total stress perception scores,HAMA scores,and anxiety,depression,and anger introversion scores,and lower optimism,anger,anger extroversion,and social support scores,peripheral blood levels of NE,E,DA,Glu,and 5-HT were decreased,and CRP level was elevated,AS incidence was increased,and the time of AS onset was shortened(P＜0.01).CPSS and HAMA scores of CAT patients in the group with anxiety and depressive symptoms were positively correlated with anxiety,depression,anger,anger introversion,and anger extroversion on the type C personality behavioral patterns questionnaire,and negatively correlated with optimism and social support(P＜0.05),but not with control and sanity(P＞0.05).One-way logistic regression analysis showed that serum levels of NE,E,DA,5-HT,Glu and CRP were risk factors for the development of AS in CAT patients(P＜0.01).Conclusion Mental stress in CAT patients is closely related to the occurrence of AS.Changes in peripheral blood neurotransmitter levels of NE,E,DA,5-HT and Glu induced by anxiety and depression are influential factors in the occurrence of AS,and the mechanism may be related to inflammatory response induced by long-term repressed state.
万方数据
维普
