No abstract available.
Echocardiography* ; Emergencies* ; Emergency Service, Hospital* ; Myocardial Ischemia*

No abstract available.
Hypertension*

Psychological stress including depression and anxiety are independent risk factors for cardiovascular disease morbidity and mortality, especially in women. Emotional regulation plays a mediating role in the development of depression and physical illness, and can alter resting physiologic responses associated with the stress response. Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. MBSR was originally developed for the management of chronic pain, which is now used widely to reduce psychological morbidity associated with chronic illnesses and to treat emotional and behavioral disorders. In cardiovascular disease, MBSR may be helpful for controlling several risk factors for coronary heart disease such as hypertension, type 2 diabetes mellitus, dyslipidemia, oxidative and psychosocial stress, obesity, and smoking, and improvements in submaximal exercise responses and heart rate variability. Although the most effective mode of stress reduction therapy is yet to be established, increasing recognition is being given to MBSR therapy.
Anxiety ; Cardiovascular Diseases* ; Chronic Disease ; Chronic Pain ; Coronary Disease ; Depression ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Female ; Heart Rate ; Heart* ; Humans ; Hypertension ; Meditation ; Mindfulness ; Mortality ; Negotiating ; Obesity ; Relaxation ; Risk Factors ; Smoke ; Smoking ; Stress, Psychological

PURPOSE: The purpose of this study was to figure out influences of supervisor's and colleague's supports, nursing work environment, ego-resilience, organizational commitment and burnout on turnover intention of nurses working in general hospitals. METHODS: The data were collected from 379 nurses working in general hospitals with more than 500 beds in S city from July 1 to August 31, 2012. The collected data were analyzed with independent t-test, one-way ANOVA, Pearson's correlation and Hierarchial regression analysis by using SPSS 19.0. RESULTS: In case the subject was young, with work experience of 1~5 years, single, female and position of general nurse, turnover intention was statistically significantly higher. Turnover intention, supervisor's support, nursing work environment, organizational commitment and ego-resilience showed significantly negative correlations, but burnout showed significantly positive correlations. In case of controlling general characteristics, higher correlational variables with turnover intention accounted for 30.2%. CONCLUSION: In order to reduce turnover intention of general nurses who showed higher intention with 1~5 years' work experience, situational variables such as organizational commitment and nursing work environment and interpersonal relation variables such as supervisor's support as well as personal variables such as ego-resilience should all be considered.
Female ; Hospitals, General ; Humans ; Intention* ; Interpersonal Relations* ; Nursing ; Regression Analysis

BACKGROUND: Although carotid intima-media thickness (IMT) is the most commonly used ultrasonic measurement of atherosclerosis, plaque burden can be also assessed by ultrasound (US). We investigated the relationship between IMT, total plaque area (TPA) and total plaque volume (TPV) in patients with coronary artery disease (CAD). METHODS: One hundred and seven patients with suspected CAD and carotid plaques identified by duplex ultrasound underwent 3-dimensional US and coronary angiography. The mean IMT, TPA, and TPV were analyzed for patients with CAD according to the severity of CAD. RESULTS: In the 107 participants, IMT, TPA and TPV averaged 0.90 +/- 0.26 mm, 0.42 +/- 0.39 cm2 and 237.0 +/- 301.2 mm3, respectively. We found significant correlations for mean IMT : TPA, mean IMT : TPV and TPA : TPV of 0.448, 0.587 and 0.873, respectively (all p < 0.005). Although there was no significant association of IMT and the severity of CAD, TPA and TPV showed significant positive correlation with CAD severity (r = 0.340, p = 0.0003 for TPA and r = 0.465, p < 0.0001 for TPV). Multivariate linear regression analysis showed age was the only significant attributor to IMT, TPA, and TPV. Mean IMT was significantly associated only with hypertension. TPA was significantly associated with male sex, hypertension, and low density lipoprotein-cholesterol (LDL-C). TPV was significantly associated with male sex, C-reactive protein, and LDL-C. CONCLUSION: Although there were significant correlations among the various US measures of carotid artery morphology, there seemed to be different biological determinants of IMT, TPA, and TPV. We might need to be selective about the particular measurements for specific applications.
Atherosclerosis ; C-Reactive Protein ; Carotid Arteries ; Carotid Intima-Media Thickness ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Hypertension ; Linear Models ; Male ; Ultrasonics

BACKGROUND AND OBJECTIVES: An association between chronic stress and cardiovascular diseases has been described, but the underlying mechanisms have not been fully elucidated. We investigate the impact of perceived stress on the left ventricular (LV) and endothelial functions in postmenopausal women. SUBJECTS AND METHODS: We investigated 64 consecutive postmenopausal women (mean age 56.7+/-9.7 years) with atypical chest pain and chronic stress. Patients with coronary heart disease were excluded. Global and segmental longitudinal deformation parameters of LV were used as parameters to assess myocardial function and brachial flow-mediated dilatation (FMD) was used to assess the endothelial function, and patients were analyzed by the Symptom Checklist 90 Revised (SCL-90-R) to determine emotional stress. The study participants were divided into two groups, based on global severity index (GSI): > or =50 (group A, n=27) or <50 (group B, n=37). RESULTS: Although there were no significant differences in LV geometry or myocardial performance indices between the groups, global LV strain was significantly reduced in group A compared to group B (-16.6+/-2.7% vs. -19.1+/-1.9%, p=0.001). There were also significant differences in the value of reactive FMD (6.6+/-2.2% vs. 9.5+/-2.9%, p<0.001), and same result was observed for nitroglycerine-induced dilatation (14.6+/-4.7% vs. 18.0+/-5.8%, p=0.016). Multivariate linear regression analysis showed that GSI was the only significant attributor to global LV strain (beta=0.149, p=0.008) and reactive FMD (beta=-0.200, p=0.041). CONCLUSION: Chronic emotional stress may exert negative effects on the LV and endothelial functions, which may be associated with the severity of stress. This study provides a possible mechanism by which stress is associated with an increased risk of cardiovascular dysfunction.
Cardiovascular Diseases ; Checklist ; Chest Pain ; Coronary Disease ; Dilatation ; Echocardiography ; Endothelium ; Female ; Humans ; Linear Models ; Sprains and Strains ; Stress, Psychological

PURPOSE: The purpose of this study was to figure out influences of supervisor's and colleague's supports, nursing work environment, ego-resilience, organizational commitment and burnout on turnover intention of nurses working in general hospitals. METHODS: The data were collected from 379 nurses working in general hospitals with more than 500 beds in S city from July 1 to August 31, 2012. The collected data were analyzed with independent t-test, one-way ANOVA, Pearson's correlation and Hierarchial regression analysis by using SPSS 19.0. RESULTS: In case the subject was young, with work experience of 1~5 years, single, female and position of general nurse, turnover intention was statistically significantly higher. Turnover intention, supervisor's support, nursing work environment, organizational commitment and ego-resilience showed significantly negative correlations, but burnout showed significantly positive correlations. In case of controlling general characteristics, higher correlational variables with turnover intention accounted for 30.2%. CONCLUSION: In order to reduce turnover intention of general nurses who showed higher intention with 1~5 years' work experience, situational variables such as organizational commitment and nursing work environment and interpersonal relation variables such as supervisor's support as well as personal variables such as ego-resilience should all be considered.
Female ; Hospitals, General ; Humans ; Intention ; Interpersonal Relations ; Nursing ; Regression Analysis

BACKGROUND: Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. In this study, we investigate the impact of MBSR on left ventricular (LV) and endothelial function in female patients with microvascular angina. METHODS: A total of 34 female patients (mean age 52.2 ± 13.8 years) diagnosed with microvascular angina underwent a MBSR program with anti-anginal medication for 8 weeks. The global longitudinal strain (GLS) of the LV was used as a parameter to assess myocardial function and reactive brachial flow-mediated dilatation (FMD) was used to assess endothelial function. Symptoms were analyzed by the Symptom Checklist 90 Revised to determine emotional stress. Changes in GLS and FMD between baseline and post-MBSR were analyzed. RESULTS: After 8 weeks of programmed MBSR treatment, stress parameters were significantly decreased. In addition, GLS (−19.5 ± 2.1% vs. −16.6 ± 2.5%, p < 0.001) and reactive FMD significantly improved (8.9 ± 3.0% vs. 6.9 ± 2.6%, p = 0.005) after MBSR compared to baseline. The changes in GLS correlated to changes in FMD (r = 0.120, p = 0.340) and with the changes in most stress parameters. CONCLUSION: MBSR has beneficial impacts on myocardial and endothelial function in female patients with microvascular angina.
Checklist ; Dilatation ; Female* ; Humans ; Meditation ; Microvascular Angina* ; Mindfulness* ; Stress, Psychological

PURPOSE: There are no sufficient data on the correlation between inter-arm blood pressure (BP) difference and coronary atherosclerosis found using coronary artery calcium score (CACS). We aimed to investigate if the increased difference in inter-arm BP is independently associated with severity of CACS. MATERIALS AND METHODS: Patients who had ≥3 cardiovascular risk factors or an intermediate Framingham Risk Score (FRS; ≥10) were enrolled. Inter-arm BP difference was defined as the absolute difference in BP in both arms. Quantitative CACS was measured by using coronary computed tomography angiography with the scoring system. RESULTS: A total of 261 patients were included in this study. Age (r=0.256, p<0.001), serum creatinine (r=0.139, p=0.030), mean of right arm systolic BP (SBP; r=0.172, p=0.005), mean of left arm SBP (r=0.190, p=0.002), inter-arm SBP difference (r=0.152, p=0.014), and the FRS (r=0.278, p<0.001) showed significant correlation with CACS. The increased inter-arm SBP difference (≥6 mm Hg) was significantly associated with CACS ≥300 [odds ratio (OR) 2.17, 95% confidence interval (CI) 1.12–4.22; p=0.022]. In multivariable analysis, the inter-arm SBP difference ≥6 mm Hg was also significantly associated with CACS ≥300 after adjusting for clinical risk factors (OR 2.34, 95 % CI 1.06–5.19; p=0.036). CONCLUSION: An increased inter-arm SBP difference (≥6 mm Hg) is associated with coronary atherosclerotic disease burden using CACS, and provides additional information for predicting severe coronary calcification, compared to models based on traditional risk factors.
Angiography ; Arm ; Atherosclerosis ; Blood Pressure* ; Calcium* ; Coronary Artery Disease ; Coronary Vessels ; Creatinine ; Humans ; Risk Factors

BACKGROUND AND OBJECTIVES: An association between emotional or physical stressful triggers and adverse cardiovascular events, such as death and myocardial infarction, has been recognized for many years. The clinical features of transient left apical ballooning syndrome have been clearly described, but the effect of chronic stress on the myocardium is unknown. Our objective was to assess left ventricular (LV) function in patients with fibromyalgia (FM) with chronic emotional and physical stress. SUBJECTS AND METHODS: We investigated 30 consecutive postmenopausal women (mean age, 48+/-8 years) satisfying the criteria for FM with atypical chest pain and 20 age-matched healthy controls by means of standard and 2-dimensional strain (2DS) echocardiography. Patients with hypertension, coronary heart disease, or diabetes were excluded. Global and segmental longitudinal deformation parameters of LV function from 3 apical views were analyzed, and patients underwent a manual tender point survey for the number of tender points and tender point counts, and completed the Fibromyalgia Impact Questionnaire (FIQ), which was comprised of physical and feel scores, the Brief Fatigue Inventory (BFI), and the Beck Depression Inventory (BDI). RESULTS: Both global and segmental longitudinal LV strains were significantly reduced in FM patients with high FIQ scores (>50) compared to FM patients with low FIQ scores (-18.98% vs. -22.72%). Various emotional and physical stress indexes were significantly correlated with global LV strain. CONCLUSION: Global and segmental LV strains were negatively associated with fatigue, tender point count, and FIQ score. However, there was no significant association between depression and LV strain. This study demonstrated that chronic emotional or physical stress in FM patients might reduce myocardial longitudinal deformation.
Chest Pain ; Coronary Disease ; Depression ; Echocardiography ; Fatigue ; Female ; Fibromyalgia ; Humans ; Hypertension ; Myocardial Infarction ; Myocardium ; Sprains and Strains ; Stress, Psychological ; Takotsubo Cardiomyopathy ; Surveys and Questionnaires