Stress-Mediated Abnormalities in Regional Myocardial Wall Motion in Young Women with a History of Psychological Trauma

Assem Aweimer; Luisa Engemann; Sameh Amar; Aydan Ewers; Faegheh Afshari; Clara Maiß; Katharina Kern; Thomas Lücke; Andreas Mügge; Ibrahim El-Battrawy; Johannes W Dietrich; Martin Brüne

doi:10.3390/jcm12216702

Stress-Mediated Abnormalities in Regional Myocardial Wall Motion in Young Women with a History of Psychological Trauma

J Clin Med. 2023 Oct 24;12(21):6702. doi: 10.3390/jcm12216702.

Authors

Affiliations

¹ Bergmannsheil Bochum, Medical Clinic II, Department of Cardiology and Angiology, Ruhr University Bochum, 44789 Bochum, Germany.
² LWL University Hospital Bochum, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr University Bochum, 44791 Bochum, Germany.
³ St. Josef-Hospital, University Hospital of Pediatrics and Adolescent Medicine, Department of Neuropediatrics and Social Pediatrics, Ruhr University Bochum, 44791 Bochum, Germany.
⁴ Diabetes, Endocrinology and Metabolism Section, Department of Medicine I, Catholic Hospitals Bochum, St. Josef University Hospital Bochum, Ruhr University Bochum, 44791 Bochum, Germany.
⁵ Diabetes Centre Bochum/Hattingen, St. Elisabeth Hospital Blankenstein, Im Vogelsang 5-11, 45527 Hattingen, Germany.
⁶ Centre for Rare Endocrine Diseases, Ruhr Centre for Rare Diseases (CeSER), Ruhr University Bochum and Witten/Herdecke University, Alexandrinenstr. 5, 44791 Bochum, Germany.
⁷ Centre for Diabetes Technology, Catholic Hospitals Bochum, Gudrunstr. 56, 44791 Bochum, Germany.

Abstract

Background: Psychosocial stress has been associated with the development and progression of atherosclerotic cardiovascular disease (CVD). Previously, we reported subtle differences in global longitudinal strain in somatically healthy women with a psychiatric diagnosis of borderline personality disorder (BPD). This study aimed to investigate the impact of BPD on segmental myocardial wall motion using speckle tracking echocardiography (STE) analysis.

Methods: A total of 100 women aged between 18 and 38 years were included in this study. Fifty patients meeting the diagnostic criteria for BPD were recruited from the Department of Psychiatry (LWL-University Hospital Bochum) and compared with fifty age-matched healthy control subjects without previous cardiac disease. Laboratory tests and STE were performed with segmental wall motion analysis.

Results: The BPD group had a higher prevalence of risk factors for CVD, with smoking and obesity being predominant, when compared with the control group. Other cardiovascular parameters such as blood pressure, glucose, and cholesterol levels were also elevated, even though not to pathological values. Moreover, in the STE analysis, the BPD group consistently exhibited decreased deformation in nine myocardial wall regions compared with the control group, along with a shift toward higher values in the distribution of peak pathological segments. Additionally, significantly higher values of free thyroxine concentration and thyroid's secretory capacity were observed in the BPD group, despite falling within the (high-) normal range.

Conclusions: BPD is associated with chronic stress, classical risk factors, and myocardial wall motion abnormalities. Further exploration is warranted to investigate the relationship between high-normal thyroid metabolism, these risk factors, and myocardial function in BPD patients. Long-term follow-up studies would be valuable in confirming the potential for predicting adverse events.

Keywords: psychological trauma; regional wall motion; risk factors; speckle tracking echocardiography; stress cardiomyopathy.

Grants and funding

RUB2021/Dr. Georg E. und Marianne Kosing Stiftung