Putative mechanisms Underlying Myocardial infarction onset and Emotions (PUME): a randomised controlled study protocol

Ipek Ensari, Matthew M Burg, Keith M Diaz, Jie Fu, Andrea T Duran, Jerry M Suls, Jennifer A Sumner, Rachel Monane, Jacob E Julian, Shuqing Zhao, William F Chaplin, Daichi Shimbo, Ipek Ensari, Matthew M Burg, Keith M Diaz, Jie Fu, Andrea T Duran, Jerry M Suls, Jennifer A Sumner, Rachel Monane, Jacob E Julian, Shuqing Zhao, William F Chaplin, Daichi Shimbo

Abstract

Introduction: The experience of negative emotions (eg, anger, anxiety and sadness) is associated with an increased short-term risk of incident cardiovascular disease (CVD) events, independent of traditional CVD risk factors. Impairment in endothelial function is one possible biological mechanism which may explain the association between negative emotions and incident CVD events. This laboratory-based, single-blind, randomised controlled experimental study aims to investigate the impact of induced negative emotions including anger, anxiety and sadness on endothelial function.

Methods and analysis: In a between-subjects design, 280 healthy participants are randomised to one of four experimental negative emotion inductions: anger, anxiety, sadness or a neutral condition. Endothelium-dependent vasodilation, circulating levels of endothelial cell-derived microparticles and bone marrow-derived endothelial progenitor cells, and indices of nitric oxide inhibition are assessed before and 3, 40, 70 and 100 min after negative emotion induction. Finally, in a subsample of 84 participants, the potential moderating effects of cardiorespiratory fitness and habitual physical activity on the adverse effects of an acute negative emotion on endothelial function are investigated.

Ethics and dissemination: This study is conducted in compliance with the Helsinki Declaration and the Columbia University Medical Center Institutional Review Board. The results of the study will be disseminated at several research conferences and as published articles in peer reviewed journals. The study will be implemented and reported in line with the SPIRIT statement.

Trial registration number: NCT01909895; Pre-results.

Keywords: basic sciences; cardiology; mental health; preventive medicine.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Timeline of events and outcome assessments during the experimental laboratory visit. *Negative emotion induction consists of one of the following emotion inductions: anger, anxious or sadness, or neutral. At each time point (ie, T1 through T5), the following outcomes measures are assessed: (1) endothelium-dependent vasodilation, endothelial-derived microparticles and early progenitor cells. IV, intravenous.

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