The impact of myocardial infarction on basal and stress-induced heart rate variability and cortisol secretion in women: A pilot study.

Coronary heart disease (CHD), of which myocardial infarction (MI) is a subtype, is the leading cause of death for women. Nonetheless, women remain neglected in CHD research, resulting in treatments and recommendations being primarily based on data collected in men. Pre-clinical and clinical studies have supported dysregulation of the hypothalamic-pituitary-adrenal axis (HPAA) following cardiac arrest and MI to promote the development of mental health disorders (e.g., major depressive disorder, post-traumatic stress disorder). However, studies addressing changes in HPAA activation under basal and stress-induced conditions in women samples have been lacking. Thus, we conducted this study to determine basal and stress-induced changes in heart rate, respiration and cortisol secretion (via 8 saliva samples) in a sample of women with a history of MI (n = 13) and a control group (n = 16). We measured altered stress reactivity through exposure to the Trier Social Stress Test. In addition, participants completed questionnaires assessing perceived stress and mental health status (i.e., anxiety and mood). Overall, our findings indicated comparable assessments of perceived situational stress in both groups. Interestingly, salivary cortisol secretion support reduced stress-induced HPAA activation related to TSST exposure in MI women compared to control counterparts. Our observations are consistent with findings supporting glucocorticoid resistance noted following MI and cardiac arrest. Akin to cardiac arrest survivors, HPAA dysregulation in MI survivors could have an impact on the development of mental health disorders. More studies are needed to address this critical question.

Neuropsychological Sequelae of Coronary Heart Disease in Women: A Systematic Review.

Heart disease, such as coronary heart disease (CHD), is the leading cause of death among aging women. However, over the past years, the mortality rate has declined, resulting in an increased number of CHD survivors. In this context, research has uncovered relationships between cardiovascular disease (CVD) and the development of neurodegenerative diseases, suggesting that CHD can act as a precursor. Despite heart disease affecting both sexes, CVD research has significantly neglected women. Therefore, we conducted the first systematic review of neuropsychological sequelae of CHD in women to gain a clear portrait of the current knowledge of the association of CHD on women's neuropsychological status. We found that studies continue to include an insufficient number of women in their research. Our work also uncovered that there is variability in the definition of CHD by researchers (i.e., operationalization of the variable), which could explain inconsistencies across studies. Overall, we found evidence that supports the heart-brain disease hypothesis. To conclude, we provide several guidelines for future research involving the impact of CHD in women.

A systematic review of the Trier Social Stress Test methodology: Issues in promoting study comparison and replicable research.

Since its development in 1993, the Trier Social Stress Test (TSST) has been used widely as a psychosocial stress paradigm to activate the sympathetic nervous system and hypothalamic-pituitary-adrenal axis (HPAA) stress systems, stimulating physiological functions (e.g. heart rate) and cortisol secretion. Several methodological variations introduced over the years have led the scientific community to question replication between studies. In this systematic review, we used the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) to synthesize procedure-related data available about the TSST protocol to highlight commonalities and differences across studies. We noted significant discrepancies across studies in how researchers applied the TSST protocol. In particular, we highlight variations in testing procedures (e.g., number of judges, initial number in the arithmetic task, time of the collected saliva samples for cortisol) and discuss possible misinterpretation in comparing findings from studies failing to control for variables or using a modified version from the original protocol. Further, we recommend that researchers use a standardized background questionnaire when using the TSST to identify factors that may influence physiological measurements in tandem with a summary of this review as a protocol guide. More systematic implementation and detailed reporting of TSST methodology will promote study replication, optimize comparison of findings, and foster an informed understanding of factors affecting responses to social stressors in healthy people and those with pathological conditions.