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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Coronary Artery Spasm, Coronary Reactivity, and Their Psychological Context
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Coronary Artery Spasm, Coronary Reactivity, and Their Psychological Context

机译：冠状动脉痉挛，冠状动脉反应性及其心理背景

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摘要

Symptomatic individuals suspected of having myocardial ischemia often have no obstructive atherosclerotic narrowing of epicardial coronary arteries. Abnormal coronary vascular reactivity and, in particular, coronary artery vasospasm (CAS) may be an explanation in a subset of these patients. Psychological factors play an important role in ischemic heart disease, but their role in CAS is not clear; autonomic dysfunction and increased inflammation are two prevailing pathophysiological mechanisms implicated in abnormal coronary reactivity resulting from mental health conditions. Interrelationships between psychological factors, abnormal coronary reactivity, and sex/gender differences are poorly defined in the etiology of CAS. In this issue of Psychosomatic Medicine (2019;81:237-245), Hung et al. report a frequency of less than 0.1% of new-onset CAS in the Taiwanese population, with higher occurrence in women and younger individuals. Patients with CAS had a higher prevalence of previous anxiety and depression compared with those with coronary artery disease and controls, with no sex differences. In this editorial comment, we discuss the potential reasons for underreporting of CAS and the challenges regarding the use of administrative health records for psychosomatic research. In this editorial, a model is presented to explain the association between emotional stressors and mental health factors with CAS, including the role of sympathetic nervous system activation, inflammation, oxidative stress, endothelial dysfunction, and smooth muscle cell dysregulation.
机译：涉嫌心肌缺血的症状常常没有外膜冠状动脉的阻塞性动脉粥样硬化窄。异常冠状动脉血管反应性，特别是冠状动脉血管痉挛（CAS）可以是这些患者的子集中的解释。心理因素在缺血性心脏病中发挥着重要作用，但它们在CA中的作用尚不清楚;自主功能障碍和增加的炎症是患有心理健康状况导致的异常冠状动脉反应性的两种普遍的病理生理机制。心理因素，异常冠状动脉反应性和性别/性别差异之间的相互关系在CA的病因中差异很差。在这一问题的心理学医学（2019年; 81：237-245）中，Hung等人。在台湾人口中报告少于0.1％的频率，妇女和年轻人出现较高。与冠状动脉疾病和对照组的人相比，患有CAS的患者对先前焦虑和抑郁症的患病率较高，没有性差异。在这方面，我们讨论了CA的潜在原因以及关于使用行政健康记录对心身研究的挑战。在这方面，提出了一种模型来解释与CAS的情绪压力源和心理健康因素之间的关联，包括交感神经系统活化，炎症，氧化应激，内皮功能障碍和平滑肌细胞诱导的作用。

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