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Titolo:
Low hot pain threshold predicts shorter time to exercise-induced angina: Results from the psychophysiological investigations of myocardial ischemia (PIMI) study
Autore:
Sheps, DS; McMahon, RP; Light, KC; Maixner, W; Pepine, CJ; Cohen, JD; Goldberg, AD; Bonsall, R; Carney, R; Stone, PH; Sheffield, D; Kaufmann, PG;
Indirizzi:
E Tennessee State Univ, Johnson City, TN 37614 USA E Tennessee State UnivJohnson City TN USA 37614 hnson City, TN 37614 USA Maryland Med Res Inst, Baltimore, MD USA Maryland Med Res Inst Baltimore MD USA d Med Res Inst, Baltimore, MD USA Univ N Carolina, Chapel Hill, NC USA Univ N Carolina Chapel Hill NC USAUniv N Carolina, Chapel Hill, NC USA Univ Florida, Gainesville, FL USA Univ Florida Gainesville FL USAUniv Florida, Gainesville, FL USA St Louis Univ, Med Ctr, St Louis, MO USA St Louis Univ St Louis MO USASt Louis Univ, Med Ctr, St Louis, MO USA Henry Ford Hosp, Detroit, MI 48202 USA Henry Ford Hosp Detroit MI USA 48202 nry Ford Hosp, Detroit, MI 48202 USA Emory Univ, Sch Med, Atlanta, GA USA Emory Univ Atlanta GA USAEmory Univ, Sch Med, Atlanta, GA USA Brigham & Womens Hosp, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 mens Hosp, Boston, MA 02115 USA NHLBI, Bethesda, MD 20892 USA NHLBI Bethesda MD USA 20892NHLBI, Bethesda, MD 20892 USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 7, volume: 33, anno: 1999,
pagine: 1855 - 1862
SICI:
0735-1097(199906)33:7<1855:LHPTPS>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; ST-SEGMENT DEPRESSION; PLASMA BETA-ENDORPHIN; MENTAL STRESS; SILENT; PECTORIS; PERCEPTION; RESPONSES; NALOXONE; EXPERIENCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Sheps, DS 2 Profess Pk Dr,Suite 15, Johnson City, TN 37604 USA 2 Profess Pk Dr,Suite 15 Johnson City TN USA 37604 TN 37604 USA
Citazione:
D.S. Sheps et al., "Low hot pain threshold predicts shorter time to exercise-induced angina: Results from the psychophysiological investigations of myocardial ischemia (PIMI) study", J AM COL C, 33(7), 1999, pp. 1855-1862

Abstract

OBJECTIVES The purpose of this study was to test whether cutaneous thermalpain thresholds are related to anginal pain perception. BACKGROUND Few ischemic episodes are associated with angina; symptoms havebeen related to pain perception thresholds. METHODS A total of 196 patients with documented coronary artery disease underwent bicycle exercise testing and thermal pain testing. The Marstock test of cutaneous sensory perception was administered at baseline after 30 minof rest on two days and after exercise and mental stress. Resting hot painthresholds (HPTs) were averaged for the two baseline visits and divided into two groups: 1) average HPT <41 degrees C, and 2) average HPT greater than or equal to 41 degrees C, to be clearly indicative of abnormal hypersensitivity to noxious heat. RESULTS Patients with HPT <41 degrees C had significantly shorter time to angina onset on exercise testing than patients with HPT <41 degrees C (p < 0.04, log rank test). Heart rates, systolic blood pressure and rate-pressure product at peak exercise were not different for the two groups. Resting plasma beta-endorphin levels were significantly higher in the HPT <41 degrees C group (5.9 +/- 3.7 pmol/liter vs. 4.7 +/- 2.8 pmol/liter, p = 0.02). Using a Cox proportional hazards model, patients with HPT <41 degrees C had an increased risk of angina (p = 0.03, rate ratio = 2.0). These differences persisted after adjustment for age, gender, depression, anxiety and historyof diabetes or hypertension (p < 0.01). CONCLUSIONS Occurrence of angina and timing of angina onset on an exercisetest are related to overall hot pirin sensory perception. The mechanism ofthis relationship requires further study. (C) 1999 by the American Collegeof Cardiology.

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Documento generato il 27/11/20 alle ore 22:00:50