The Clinical Feature of Regional Wall Motion Abnormality on Apex of the Left Ventricle with Normal Coronary Angiogram

Chung, Joong Wha; Kang, Min Jeong; Kim, Young Hoon; Chang, Jae Hyuk; Ha, Sung Il; Kim, Hee Joong; Koh, Young Youp; Chang, Kyoung Sig; Hong, Soon Pyo

Abstract

BACKGROUND AND OBJECTIVES
Stress induced cardiomyopathy has been reported as reversible left ventricular dysfunction with electrocardiographic changes. Although the exact mechanism of this dysfunction has not been clarified, catecholamine "surge" is suspected as a potential cause of this disease. It has not been undergone the studies about the effect of chronic or recurrent psychological stress on the myocardium. We suspect that reversible ischemic change of myocardium could be induced by chronic or recurrent emotional stress. MATERIALS AND METHOD: The clinical, echocardiographic and angiographic data of 189 patients (72 women) who presented with ischemic symptoms and eletrocardiographic changes were participated. BAI (Beck anxiety inventory) and BDI (Beck Depression inventory) were obtained and analyzed for evaluation of degree of psychological stress.
RESULTS
54 patients who had left ventricular apical wall motion abnormalities without significant angiographical stenosis in the coronary artery were younger than the others with left ventricular wall motion abnormalities and angiographic stenosis. And they increased the BAI and BDI as tools of evaluation of psychological stress (p<0.05).
CONCLUSION
Data of this study suggested that psychological stress can be associated with myocardial dysfunction. It can be postulated that psychological stress should be considered as one of the cause of non-coronary myocardial injury.