心筋梗塞患者の行動パターンと心理的ストレスに対する心血管系反応

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タイトル別名
  • Behavior Pattern and Cardiovascular Response to Emotional Stress in Patients With Acute Myocardial Infarction
  • シンキン コウソク カンジャ ノ コウドウ パターン ト シンリテキ ストレス

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抄録

Many questions were unawared concerning the mechanism of type A behavior pattern in relation to development of coronary heart diseases. The author attempted to investigate cardiovascular responses of type A patients with acute myocardial infarction by an emotional stress test. Sixty-two inpatients with acute myocardial infarction (under 59 years of age) were observed. All patients were in I or II grade of Killip's severity criteria at the early stage of illness and showed good recovery process. Using mirror drawing test as a mental stress load, changes of blood pressure, pulse rate and plasma catecholamines were examined. Behavior patterns were assessed by JAS (Jenkins Activity Survey) which was translated into Japanese by the Department of Psychosomatic Medicine of Tohoku University. The subjects included some acute myocardial infarction patients with treated hypertension (in I or II grade of WHO classification). As a result, by combining behavior pattern and blood pressure level, 62 subjects were classified into the following 4 groups. Group A : type A hypertensives (19 cases) Group B : type A normotensives (22 cases) Group C : type B hypertensives (9 cases) Group D : type B normotensives (12 cases) The results were as follows. 1) Mirror drawing test stress evoked more elevation of blood pressure and plasma catecholamine level in type A patients than in type B patients. 2) Marked effects to increase systolic blood pressure and plasma noradrenaline level by Mirror drawing test were seen in group A, moderate effects were in groups B and C, contrary slight effects were in group D. Statestcally significant differences in mirror drawing test stress were seen in systolic blood pressure changes between group A and group B(p<0.05), group A and group D(p<0.01), and in plasma noradrenaline changes between group A and group D(p<0.05). 3) These results suggested that acute myocardial infarction patients with type A bahavior pattern had cardiovascular hyperreacivity based on hypersusceptibility of sympathetic adrenal medullary system.

収録刊行物

  • 心身医学

    心身医学 30 (7), 625-631, 1990

    一般社団法人 日本心身医学会

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