Real‐Life Psychological Experiences and Cardiac Autonomic Physiology Among Survivors of a Myocardial Infarction in Midlife
5 affiliations
- 1Emory University
- 2Emory University School of Medicine
- 3Georgia Institute of Technology
- 4Veterans Administration Medical Center
- 5University of Alberta
Abstract
Middle-aged women with ischemic heart disease have a higher burden of psychosocial factors compared with male counterparts. Data on daily life stress and autonomic physiology could help guide targeted interventions. We studied 302 individuals ≤ 61 years of age (129 women and 173 men) recently hospitalized for a myocardial infarction (MI). All underwent a 7-day home monitoring of mood and stress using ecological momentary assessments, with concomitant Holter monitoring for autonomic physiology. Deceleration capacity (DC), a prognostic marker of parasympathetic activity, was the primary autonomic outcome. Across the week of monitoring, women reported higher levels and variability of negative mood and stress than men, with no differences in positive mood. Women also exhibited significantly lower parasympathetic activity (the daily averaged of DC) compared with men. Heart rate variability was also lower. Among women, but not men, daily negative mood was inversely associated with lower DC: for each 1-log unit higher daily negative mood score DC declined 4.5% in women, with no change in men (p=0.02 for interaction). Women with early-onset MI have more parasympathetic withdrawal than men in daily life, especially during moments of negative mood. These results underscore the need for greater attention to psychosocial management in post-MI women.
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BibTeX
@article{vaccarino2026reallife,
title = {{Real‐Life Psychological Experiences and Cardiac Autonomic Physiology Among Survivors of a Myocardial Infarction in Midlife}},
author = {Viola Vaccarino and Hua She and Lisa Elon and Tené T. Lewis and Yi‐An Ko and Gari Clifford and Quiao Li and Nancy Murrah and Lucy H. Shallenberger and Tatum Roberts and Lewam Stefanos and Eric Fan‐Lou and J. Douglas Bremner and Paolo Raggi and Arshed Quyyumi and Amit J. Shah},
journal = {Journal of the American Heart Association},
year = {2026},
month = oct,
doi = {10.1161/jaha.126.052187},
url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.052187},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Real‐Life Psychological Experiences and Cardiac Autonomic Physiology Among Survivors of a Myocardial Infarction in Midlife
AU - Viola Vaccarino
AU - Hua She
AU - Lisa Elon
AU - Tené T. Lewis
AU - Yi‐An Ko
AU - Gari Clifford
AU - Quiao Li
AU - Nancy Murrah
AU - Lucy H. Shallenberger
AU - Tatum Roberts
AU - Lewam Stefanos
AU - Eric Fan‐Lou
AU - J. Douglas Bremner
AU - Paolo Raggi
AU - Arshed Quyyumi
AU - Amit J. Shah
PY - 2026
DA - 2026/10/20
JO - Journal of the American Heart Association
DO - 10.1161/jaha.126.052187
UR - https://www.ahajournals.org/doi/10.1161/JAHA.126.052187
AB - Middle-aged women with ischemic heart disease have a higher burden of psychosocial factors compared with male counterparts. Data on daily life stress and autonomic physiology could help guide targeted interventions. We studied 302 individuals ≤ 61 years of age (129 women and 173 men) recently hospitalized for a myocardial infarction (MI). All underwent a 7-day home monitoring of mood and stress using ecological momentary assessments, with concomitant Holter monitoring for autonomic physiology. Deceleration capacity (DC), a prognostic marker of parasympathetic activity, was the primary autonomic outcome. Across the week of monitoring, women reported higher levels and variability of negative mood and stress than men, with no differences in positive mood. Women also exhibited significantly lower parasympathetic activity (the daily averaged of DC) compared with men. Heart rate variability was also lower. Among women, but not men, daily negative mood was inversely associated with lower DC: for each 1-log unit higher daily negative mood score DC declined 4.5% in women, with no change in men (p=0.02 for interaction). Women with early-onset MI have more parasympathetic withdrawal than men in daily life, especially during moments of negative mood. These results underscore the need for greater attention to psychosocial management in post-MI women.
SN - 2047-9980
ER -