Moderate to high psychosocial stress was independently associated with a lower B-MORE range in females (β = -0.246; 95% CI -4.436 to -0.134; p=0.038), but not in males.
Observational (n=142)
No
Does psychosocial stress differentially affect coronary vascular function assessed by OS-CMR in males versus females?
Psychosocial stress is associated with impaired coronary vascular function (assessed by OS-CMR) in females but not in males, highlighting sex-specific pathophysiological effects of stress.
Effect estimate: β -0.246 (95% CI -4.436 to -0.134)
Absolute Event Rate: 154% vs 193%
p-value: p=0.038
Abstract Introduction Sex-based differences in cardiovascular disease may stem from differential physiological responses to psychosocial stress. While baseline myocardial oxygenation has been studied, dynamic adaptation to stress remains poorly understood. We investigated sex-specific differences in coronary vascular function as assessed by the Breathing-enhanced Myocardial Oxygenation Response (B-MORE) using Oxygenation-Sensitive Cardiovascular Magnetic Resonance (OS-CMR), specifically using a novel biomarker—B-MORE range—derived from the Oxygenation Cardiogram (OCG). Methods In this prospective single-centre study, we included individuals with cardiovascular risk factors (obesity BMI 30 kg/m², hypertension SBP ≥ 140 mmHg or DBP ≥ 90 mmHg, or smoking) and healthy volunteers. All participants underwent OS-CMR on a 3T GE Premier scanner. Psychosocial stress was assessed using the Perceived Stress Scale (PSS), stratifying subjects into low (PSS 14) and moderate to high (PSS ≥14) stress groups. Myocardial oxygenation was evaluated using a vasoactive breathing protocol: hyperventilation (inducing vasoconstriction with lower myocardial oxygenation/ decreased myocardial signal intensity SI) followed by a long voluntary breath-hold, causing vasodilation and increased myocardial oxygenation/SI). The resulting SI curve, plotted as the OCG, was used to calculate the B-MORE range, defined as the percent change between minimum and maximum global myocardial SI during breath-hold (Figure 1). Image analysis was performed using a certified software. Cardiovascular risk was estimated using the Framingham risk score (FRS). Comparisons between sex and stress groups were made using independent t-tests. Multivariable linear regression was conducted to explore associations. Results We enrolled 142 participants (94 at risk for CVD and 48 healthy participants), of whom 70 were in the low-stress group (55.7±9.8 years; 56.6% females) and 72 in the moderate to high stress group (52.6±10.4 years; 54.3% females). High-stress females had significantly lower B-MORE range values compared to females with low stress (193±62 vs. 154 ± 53; p = 0.04). No differences in B-MORE range were observed in males between the low and moderate to high stress groups (203±87 vs. 204 ± 83; p = 0.945) (Figure 2). Multiple regression model revealed that, accounting for the FRS, the PSS score was an independent predictor of B-MORE range in females (β = –0.246, 95% CI: –4.436 to –0.134, p = 0.038), but not in males (β = 0.026, 95% CI: –3.768 to 3.074, p = 0.840). Conclusion Our results suggest that stress adversely affects coronary vascular function in females, but not in males. These preliminary findings contribute to understanding the sex-specific pathophysiological effects of stress on cardiovascular disease progression. Breathing-enhanced OS-CMR emerges as a promising non-invasive biomarker for assessing coronary vascular function. Further validation in larger cohorts is warranted.BMORE Range Visualization from OCG Curve Impact of Stress on BMORE Range by Sex
Moukarzel et al. (Thu,) conducted a observational in Cardiovascular risk factors (n=142). Moderate to high psychosocial stress (PSS ≥14) vs. Low psychosocial stress (PSS <14) was evaluated on B-MORE range in females (β -0.246, 95% CI -4.436 to -0.134, p=0.038). Moderate to high psychosocial stress was independently associated with a lower B-MORE range in females (β = -0.246; 95% CI -4.436 to -0.134; p=0.038), but not in males.