Korean Circ J.  2010 Feb;40(2):74-80. 10.4070/kcj.2010.40.2.74.

Assessment of Myocardial Function in Patients With Fibromyalgia and the Relationship to Chronic Emotional and Physical Stress

• Cho KI
• Lee JH
• Lee HG
• Kim SM
• Kim TI

• KMID: 2297942
• DOI: http://doi.org/10.4070/kcj.2010.40.2.74

Abstract

BACKGROUND AND OBJECTIVES
An association between emotional or physical stressful triggers and adverse cardiovascular events, such as death and myocardial infarction, has been recognized for many years. The clinical features of transient left apical ballooning syndrome have been clearly described, but the effect of chronic stress on the myocardium is unknown. Our objective was to assess left ventricular (LV) function in patients with fibromyalgia (FM) with chronic emotional and physical stress.
SUBJECTS AND METHODS
We investigated 30 consecutive postmenopausal women (mean age, 48+/-8 years) satisfying the criteria for FM with atypical chest pain and 20 age-matched healthy controls by means of standard and 2-dimensional strain (2DS) echocardiography. Patients with hypertension, coronary heart disease, or diabetes were excluded. Global and segmental longitudinal deformation parameters of LV function from 3 apical views were analyzed, and patients underwent a manual tender point survey for the number of tender points and tender point counts, and completed the Fibromyalgia Impact Questionnaire (FIQ), which was comprised of physical and feel scores, the Brief Fatigue Inventory (BFI), and the Beck Depression Inventory (BDI).
RESULTS
Both global and segmental longitudinal LV strains were significantly reduced in FM patients with high FIQ scores (>50) compared to FM patients with low FIQ scores (-18.98% vs. -22.72%). Various emotional and physical stress indexes were significantly correlated with global LV strain.
CONCLUSION
Global and segmental LV strains were negatively associated with fatigue, tender point count, and FIQ score. However, there was no significant association between depression and LV strain. This study demonstrated that chronic emotional or physical stress in FM patients might reduce myocardial longitudinal deformation.

Keyword

Fibromyalgia; Emotional stress; Echocardiography; Strains

MeSH Terms

Chest Pain
Coronary Disease
Depression
Echocardiography
Fatigue
Female
Fibromyalgia
Humans
Hypertension
Myocardial Infarction
Myocardium
Sprains and Strains
Stress, Psychological
Takotsubo Cardiomyopathy
Surveys and Questionnaires

Figure

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  Fig. 1 A case of longitudinal strain analysis in patients with FMS and a low FIQ score by 2-dimensional speckle tracking strain analysis, which showed normal segmental and global left ventricular strain. FMS: fibromyalgia syndrome, FIQ: Fibromyalgia Impact Questionnaire.

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  Fig. 2 A case of longitudinal strain analysis in patients with FMS and a high FIQ score by 2-dimensional speckle tracking strain analysis, which showed abnormal segmental and global left ventricular strain. FMS: fibromyalgia syndrome, FIQ: fibromyalgia impact questionnaire.

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  Fig. 3 Correlation between parameters of stress and global left ventricular strain (GLS). The value of the GLS showed modest negative correlation with parameters of physical stress score, Fibromyalgia Impact Questionnaire (FIQ), tender point counts, and fatigue (all p<0.01).

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