Mental stress reduces blood flow to the heart in patients with gene...( GAINESVILLE Fla. University of Flor...)

GAINESVILLE, Fla. University of Florida researchers have identified a gene variation in heart disease patients who appear especially vulnerable to the physical effects of mental stress to the point where blood flow to the heart is greatly reduced.

Searching for the presence of this gene may be one way to better identify patients who are at an increased risk for the phenomenon, said David S. Sheps, M.D., a professor and associate chairman of cardiovascular medicine at UFs College of Medicine and the Malcom Randall Veterans Affairs Medical Center.

Those with the gene variation are three times more likely to experience dangerous decreases in blood flow to the heart a condition doctors call ischemia than heart disease patients without it. Ischemia increases the chance these patients will suffer a heart attack, heart rhythm abnormalities or sudden death, UF researchers report in the April 14 issue of Archives of Internal Medicine.

Theres no question that in certain populations it is associated with worse prognosis than in patients who do not have mental stress-induced ischemia in terms of overall adverse events and also mortality, Sheps said. And it has become apparent that it is far more prevalent than we initially thought. Most of the studies that have been published to date have involved populations of patients who had coronary disease and positive exercise stress tests. But recently we and other investigators have shown that a much broader category of patients also are prone to mental stress ischemia.

Past studies have shown that as many as two-thirds of patients with coronary artery disease who experience exercise-related reductions in blood flow to the heart respond similarly to mental stress. These bouts often produce no symptoms of chest pain and are rarely detectable on a standard electrocardiogram. Yet previous UF research has shown that these patients have a threefold greater risk of dying as large a risk factor as
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