Heart failure: stress puts a strain on cardiac output
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More posts by Christiane Fux All content is checked by medical journalists.Stress and anger can worsen the fitness of already weakened hearts. This effect can still be seen after days.
In some people, the heart is damaged or weakened. The heart's output capacity is then often reduced: with each heartbeat, it pumps less blood into the circulation than a healthy heart. Doctors speak of systolic heart failure (systolic heart failure).
Negative feelings in the protocol
Researchers at Yale University have now investigated how stress and anger affect the performance of the heart in people with systolic heart failure. To this end, they recruited 24 participants with heart failure, including 23 men and one woman whose heart was weakened due to calcification of the coronary arteries (coronary artery disease).
Over a period of one week, the participants recorded daily what stress, anger or other negative emotions they had experienced in the previous 24 hours.
They then subjected themselves to a standardized stress test: They worked on worksheets in which they solved challenging mathematical problems and reported on a particularly stressful experience from their past.
Both during rest periods and during the stress test, the researchers performed a so-called heart echo (echocardiography), which records the participants' heart activity.
Heart muscle relaxes poorly
For the evaluation, the scientists concentrated on the diastolic function of the heart. This describes the ability of the heart to relax between two beats in order to fill up with blood again. For patients with systolic heart failure, an additional poor diastolic function means an unfavorable prognosis. It is associated with a higher risk of complications.
Patients who had been stressed or annoyed the week before tended to show poorer diastolic function. If the heart muscle can no longer relax properly and expand, the heart chamber does not fill up completely. As a result, the heart ends up pumping even less blood into the circulation.
The more pronounced the exposure to stress or anger, the more it affected the diastolic heating output.
Reduced quality of life, higher risk of complications
"There is clear evidence that patients who have chronically elevated stress levels suffer more from the disease, have a reduced quality of life and are at higher risk of serious complications," says Harries. This is particularly true in times of Covid-19.
The study now shows that not only long-term stress can weaken the heart, but that the immediate stress also plays a role in the current performance of the heart. However, the informative value of the study is limited because the number of participants was small and the duration of the study was short.
Poor heart function, poor quality of life
In fact, patients with heart failure are often emotionally stressed because of their illness. Since the body is not supplied with sufficient blood and therefore also with oxygen, cardiac insufficiency is associated with reduced performance, which in turn can massively reduce the quality of life.
"Factors such as mental stress and anger are not given enough attention and addressed," says study director Matthew Burg. The study thus extends the list of heart diseases that are negatively influenced by stress and anger. This also included cardiac arrhythmias and arteriosclerosis, for example.
Stress accelerates heat stroke
Everyone knows from personal experience that emotions and heart function are closely related. With stress and fear, but also with positive excitement, the heartbeat accelerates. The clock is set by the so-called sympathetic nervous system, that part of the nervous system that speeds up the body's reactions. It is activated by various hormones such as adrenaline, noradrenaline and cortisol. Conversely, however, the heartbeat can also be calmed down again using mental techniques.
Stress management could help
Burg also emphasizes that stress management techniques have been shown to counteract the negative effects of stress on the course of various diseases. It is therefore important to check a possible positive effect for people with cardiac insufficiency.
In Germany, around one to two percent of the population suffer from cardiac insufficiency. That is up to 1.66 million people. In addition to the systolic heart failure described here, there is also the diastolic form, in which the ability of the heart muscle to expand is fundamentally restricted - for example due to hardening or scarring. Here the diastolic dysfunction described above does not only occur for a limited time, but also permanently.
