Cross-sectional study on the impact of adverse childhood experiences on coronary flow reserve in male physicians with and without occupational burnout

• Published in: Journal of psychosomatic research 2024-06, Vol.181, p.111672, Article 111672
• Main Authors: von Känel, Roland, Princip, Mary, Holzgang, Sarah A., Giannopoulos, Andreas A., Kaufmann, Philipp A., Buechel, Ronny R., Zuccarella-Hackl, Claudia, Pazhenkottil, Aju P.
• Format: Article
• Language: English
• Subjects: Adult; Adverse Childhood Experiences - psychology; Adverse Childhood Experiences - statistics & numerical data; Burnout; Burnout, Professional - physiopathology; Burnout, Professional - psychology; Cardiovascular disease; Coronary angiography; Coronary Circulation - physiology; Cross-Sectional Studies; Early life stress; Health care workers; Humans; Male; Middle Aged; Myocardial blood flow; Physicians - psychology; Stress, Psychological - physiopathology; Stress, Psychological - psychology; Surveys and Questionnaires
• ISSN: 0022-3999; 1879-1360; 1879-1360
• DOI: 10.1016/j.jpsychores.2024.111672

Physicians face documented challenges to their mental and physical well-being, particularly in the forms of occupational burnout and cardiovascular disease. This study examined the previously under-researched intersection of early life stressors, prolonged occupational stress, and cardiovascular health in physicians. Participants were 60 practicing male physicians, 30 with clinical burnout, defined by the Maslach Burnout Inventory, and 30 non-burnout controls. They completed the Adverse Childhood Experiences (ACE) Questionnaire asking about abuse, neglect and household dysfunctions before the age of 18, and the Perceived Stress Scale to rate thoughts and feelings about stress in the past month. Endothelium-independent (adenosine challenge) coronary flow reserve (CFR) and endothelium-dependent CFR (cold pressor test) were assessed by positron emission tomography-computed tomography. The segment stenosis score was determined by coronary computed tomography angiography. Twenty-six (43%) participants reported at least one ACE and five (8%) reported ≥4 ACEs. A higher ACEs sum score was associated with lower endothelium-independent CFR (r partial (rp) = −0.347, p = .01) and endothelium-dependent CFR (rp = −0.278, p = .04), adjusting for age, body mass index, perceived stress and segment stenosis score. In exploratory analyses, participants with ≥4 ACEs had lower endothelium-independent CFR (rp = −0.419, p = .001) and endothelium-dependent CFR (rp = −0.278, p = .04), than those with