Association of Vascular and Inflammatory miRNAs with Psychological stress and Heart Rate Variability Biofeedback Public

Abstract

Psychological stress can trigger acute cardiovascular events, especially in patients with coronary heart disease (CHD). Certain microRNAs (miRs) signal active inflammation and may serve as a biomarker to predict CHD events. We investigated the association of CHD-related miRs with acute psychological stress, as well as before/after a stress reduction intervention. Additionally, we examined which parameters predicted changes with stress. We conducted a randomized controlled pilot study of heart rate variability biofeedback (HRVB) versus waitlist control in subjects with known CAD. Of 25 patients enrolled, data were available for 22 participants, of which 13 received HRVB and 9 were placed in the waitlist control group. Stress was introduced via a three-minute mathematics test during each visit, and miRs (126-5p, 126-3p, 223) in blood samples were measured using relative expression. Hemodynamic and vascular functions were assessed and evaluated as well. The median miR levels increased with acute mental stress, although the difference was not statistically significant. HRVB was associated with decreased changes with stress in miR-126-3p (p = 0.0002) and miR-126-5p (p < 0.0001). Significant risk factors that predicted miR levels included: race, gender, waist-hip ratio (WHR), systolic blood pressure (SBP), open heart surgery, diabetes, functional capacity, and mental stress-induced myocardial ischemia (MSIMI).

Table of Contents

 

 

 

Table of Contents

 

Background ......................................................................................................................... 1

 

Methods............................................................................................................................... 4

 

Participant population ..................................................................................................... 4

 

Clinical protocol.............................................................................................................. 4

 

Statistical analysis ........................................................................................................... 6

 

Results ................................................................................................................................. 8

 

Discussion ......................................................................................................................... 11

 

Strengths and Weaknesses ................................................................................................ 13

 

Future Directions .............................................................................................................. 13

 

References ......................................................................................................................... 14

 

Tables ................................................................................................................................ 18

 

Table 1 .......................................................................................................................... 18

 

Table 2 .......................................................................................................................... 19

 

Table 3 .......................................................................................................................... 20

 

Table S1 ........................................................................................................................ 21

 

Figures and Figure Legends .............................................................................................. 22

 

Figure 1 ......................................................................................................................... 22

 

Figure 2 ......................................................................................................................... 23

 

Figure S1 ....................................................................................................................... 30

 

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About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Mental Health Health Sciences, Epidemiology
Mot-clé	Stress HRVB miR-126 miR-223 microRNA CHD
Committee Chair / Thesis Advisor	Shah, Amit, Emory University
Partnering Agencies	Hospital or other health care provider

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