The Role of Prolonged Stress and the Functional State of the Endothelium in the Development of Autonomic Dystonia Syndrome

Objective – to study the role of prolonged stress and the functional state of the endothelium in the development of autonomic dystonia syndrome (ADS) in young patients. Materials and methods. A total of 75 male patients aged 17–28 years with ADS were investigated. Group 1 included 41 patients with no clinically significant signs of psychoemotional stress; group 2 included 34 patients with high levels of psychoemotional stress; the reference group consisted of healthy subjects (n = 21). Anxiety levels were assessed using the Spielberger–Hanin self-assessment scale and the functional state of the endothelium was evaluated using an endothelium-dependent vasodilatation (EDV) test; a standard physical exercise test (PET) using a bicycle ergometer was also performed. Results and conclusions. Correlational relationships were found between reactive and trait anxiety in all groups. These values were maximal among patients with high levels of psychoemotional stress, reflecting high levels of anxiety. Patients of group 1 showed a common reactivity of vascular walls in the EDV and PET tests, while group 2 showed the opposite reactions in these tests – both increases and decreases in the diameters of the brachial artery. This appears to result from an increase in the lability of the sympathetic branch of the autonomic nervous system on the background of stress. These data lead to the conclusion that prolonged emotional stress in young patients with ADS induces dysfunction of the endothelium of the vascular wall, exacerbating the severity of clinical signs of disease and leading to an increased risk of developing cardiovascular pathology.

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