# Sex-Specific Patterns of Myocardial Ischemia During Mental and Conventional Stress

> **NIH NIH F32** · EMORY UNIVERSITY · 2020 · $64,926

## Abstract

Abstract
Cardiovascular disease (CVD) continues to be a leading cause of disability and premature mortality in the
United States and globally, Recently, young women have been found to be disproportionately affected by CVD
with rising incident of myocardial infarctions raising concerns for potentially novel disease mechanisms and risk
factors. Psychosocial stress is believed to play a role in the pathogenesis of coronary artery disease and
myocardial infarction among this vulnerable patient population. At the same time, recent studies have shown
that stress might be implicated in the differential pattern of CVD among men and women as they may have
different incidence and mechanisms of cardiovascular proclivity to stress. However, key sex-related differences
in biomarkers and mechanisms remain elusive. Therefore, the identification of differences in the pattern of
myocardial ischemia during mental and physical stress will allow for the better characterization of at-risk
populations and may facilitate understanding mechanisms of myocardial ischemia during mental stress and its
relation to non-obstructive coronary artery disease. In this application, we will develop and use a novel
algorithm applied to rest/stress myocardial perfusion imaging studies in conjunction with coronary angiography
results from the Myocardial Infarction and Mental Stress 2 (MIMS-2) database to quantify regional
homogeneity of myocardial ischemia. Aim 1 will compare the pattern of myocardial ischemia (focal vs diffuse)
in men and women and during mental and physical stress. In Aim 2, we will investigate the association of
diffuse mild myocardial ischemia as quantified by the novel algorithm with adverse cardiovascular outcomes.
The proposed analyses will provide plausible evidence to understand the effects of diffuse myocardial ischemia
on coronary artery function and myocardial blood flow at the levels of blood vessel segments and its
association with adverse cardiovascular outcomes. Additionally, this research will provide a context to use in
our interpretations of subjects improve our understanding of susceptibility to myocardial ischemia and the
relationship between myocardial ischemia, mental stress and coronary artery disease.

## Key facts

- **NIH application ID:** 9911804
- **Project number:** 1F32HL151163-01
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Zakaria Almuwaqqat
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $64,926
- **Award type:** 1
- **Project period:** 2020-07-01 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9911804

## Citation

> US National Institutes of Health, RePORTER application 9911804, Sex-Specific Patterns of Myocardial Ischemia During Mental and Conventional Stress (1F32HL151163-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9911804. Licensed CC0.

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