{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:30:11Z","timestamp":1788996611939,"version":"build-2803163510"},"reference-count":47,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"unspecified","delay-in-days":96,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 62472207"],"award-info":[{"award-number":["No. 62472207"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["No. 2025A1515011164"],"award-info":[{"award-number":["No. 2025A1515011164"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004000","name":"Guangzhou Municipal Science and Technology Program key projects","doi-asserted-by":"publisher","award":["2023B03J1249"],"award-info":[{"award-number":["2023B03J1249"]}],"id":[{"id":"10.13039\/501100004000","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291726103638_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mental stress-induced myocardial ischemia (MSIMI) is common in women with angina with no obstructive coronary artery disease (ANOCA) and is associated with adverse cardiovascular outcomes. Interleukin-6 (IL-6), a central mediator of chronic inflammation, predicts future cardiovascular risk, but its relationship with MSIMI remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726103638_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Eighty women with ANOCA underwent\n                      <jats:sup>13<\/jats:sup>\n                      N-ammonia positron emission tomography\/computed tomography to assess myocardial perfusion and myocardial blood flow (MBF) at rest, during mental stress, and during adenosine-induced stress. Resting inflammatory biomarkers were measured, and multivariable logistic and linear regression models were used to evaluate associations with mental stress-induced perfusion defects. Proteomic profiling was performed in a selected subset to explore potential underlying mechanisms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726103638_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mental stress induced significantly greater myocardial perfusion defects in MSIMI+ patients. Resting IL-6 levels were significantly higher in MSIMI+ patients (3.20 versus 1.80\u00a0pg\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.024). Although baseline CRP, hsCRP, and complement C3 levels were also higher in MSIMI+ patients, only resting IL-6 remained independently associated with both the presence of MSIMI and the severity of mental stress-induced myocardial perfusion defects after adjustment for demographic, clinical, and psychosocial factors, and resting MBF. Proteomic analyses demonstrated enrichment of innate immune\u2013hemostatic pathways and mitochondrial oxidative phosphorylation in MSIMI+ patients with high IL-6 levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726103638_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated resting IL-6 is independently associated with the presence and severity of MSIMI in women with ANOCA. These findings suggest that IL-6 may serve as a biomarker of MSIMI and support IL-6-related inflammation as a key pathophysiological pathway underlying MSIMI, with potential implications for targeted therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291726103638","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T08:28:51Z","timestamp":1775550531000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Dose-dependent association between elevated resting IL-6 levels and severity of mental stress-induced myocardial perfusion defects"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2247-4306","authenticated-orcid":false,"given":"Han","family":"Yin","sequence":"first","affiliation":[{"name":"Southern University of Science and 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