UCL RESEARCH DEPARTMENT OF EPIDEMIOLOGY AND PUBLIC HEALTH

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Silent Ischemia Study

The Silent Ischemia Study (SIS) is an investigation of emotional and behavioural factors influencing biological regulation and myocardial function in patients with coronary artery disease. Its aims are:

• To assess the relationship between myocardial ischaemia in everyday life and emotional and behavioural factors, using a new method of evaluating people’s daily experience (the Day Reconstruction Method).
• To investigate relationships between emotional and behavioural factors and psychobiological measures in everyday life, including heart rate variability and salivary cortisol.
• To analyse the association between myocardial ischaemia, cortisol, heart rate variability, and depression and quality of life.
• To study the relationship between heart rate variability, cortisol and myocardial ischemia and depression and quality of life.
• To study the relationship between sleep quality, heart rate variability and cortisol in patients with coronary artery disease.

The study involves patients with suspected or confirmed coronary artery disease carrying out 24-hour ECG (Holter) monitoring, together with measures of physical activity and salivary cortisol. After the monitoring period, patients complete the day reconstruction interview. Patients are being followed up at 6 months. Data collection started in 2005 and is continuing

The study is funded through a programme grant from the British Heart Foundation. Collaborators include Dr Roby Rakhit (Royal Free Hospital). People involved in the study include Mimi Bhattacharyya and Daisy Whitehead.

Key references:

Bhattacharyya, M.R., Molloy, G.J., and Steptoe, A. (2008). Depression is associated with flatter cortisol rhythms in patients with coronary artery disease. Journal of Psychosomatic Research, 65, 107-113.

Bhattacharyya, M. R., Whitehead, D.L., Rakhit, R., and Steptoe, A. (2008). Depressed mood positive affect, and heart rate variability in patients with suspected coronary artery disease. Psychosomatic Medicine, 70, 1020-1027.

Randall, G., Bhattacharyya, M., and Steptoe, A. (2009). Marital status and heart rate variability in patients with suspected coronary artery disease. Annals of Behavioral Medicine, 38, 115-123.