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Title: Positive and negative affect is related to experiencing chest pain during exercise-induced myocardial ischemia
Authors: Stebenne, Philippe
Bacon, Simon L.
Austin, Anthony
Paine, Nicola J.
Arsenault, Andre
Laurin, Catherine
Meloche, Bernard
Gordon, Jennifer
Dupuis, Jocelyn
Lavoie, Kim L.
Keywords: Positive affect
Negative affect
Silent ischemia
Chest pain
Coronary heart disease
Issue Date: 2017
Publisher: © American Psychosomatic Society. Published by Lippincott, Williams & Wilkins
Citation: STEBENNE, P. ... et al., 2017. Positive and negative affect is related to experiencing chest pain during exercise-induced myocardial ischemia. Psychosomatic Medicine, 79(4), pp. 395-403.
Abstract: © 2017 by the American Psychosomatic Society. Objective: Silent myocardial ischemia is thought to be associated with worse cardiovascular outcomes due to a lack of perception of pain cues that initiate treatment seeking. Negative affect (NA) has been associated with increased pain reporting and positive affect (PA) with decreased pain reporting, but these psychological factors have not been examined within the context of myocardial ischemia. This study evaluated the associations between PA, NA, and chest pain reporting in patients with and without ischemia during exercise testing. Methods: A total of 246 patients referred for myocardial perfusion single-photon emission computed tomography exercise stress testing completed the positive and negative affect schedule-expanded version, a measure of PA and NA. Presence of chest pain and myocardial ischemia were evaluated using standardized protocols. Results: Logistic regression analyses revealed that for every 1-point increase in NA, there was a 13% higher chance for ischemic patients (odds ratio [OR] = 1.13; 95 % confidence interval [CI] = 1.02 to 1.26) and an 11% higher chance in nonischemic patients (OR = 1.11; 95% CI = 1.03 to 1.19) to report chest pain. A significant interaction of PA and NA on chest pain reporting (ß = 0.02; 95% CI = 0.002 to 0.031) was also observed; nonischemic patients with high NA and PA reported more chest pain (57%) versus patients with low NA and low PA (13%), with high NA and low PA (17%), and with high PA and low NA (7%). Conclusions: Patients who experience higher NA are more likely to report experiencing chest pain. In patients without ischemia, high NA and PA was also associated with a higher likelihood of reporting chest pain. Results suggest that high levels of PA as well as NA may increase the experience and/or reporting of chest pain.
Description: This paper was accepted for publication in the journal Psychosomatic Medicine and the definitive published version is available at https://doi.org/10.1097/PSY.0000000000000427
Sponsor: Funding for data collection was provided by an operating grant from the Heart and Stroke Foundation of Quebec (HSFQ), and investigator awards from the Canadian Institutes of Health Research (CIHR) and the Fonds de recherche du Quebec: Sante (FRQS) (KLL & SLB).
Version: Accepted for publication
DOI: 10.1097/PSY.0000000000000427
URI: https://dspace.lboro.ac.uk/2134/34444
Publisher Link: https://doi.org/10.1097/PSY.0000000000000427
ISSN: 0033-3174
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)

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