Effects of verbal suggestion on coronary arteries: results of a randomized controlled experimental investigation during coronary angiography

Am Heart J. 2011 Sep;162(3):507-11. doi: 10.1016/j.ahj.2011.06.016. Epub 2011 Aug 11.


Background: Decrease of chest pain perception under placebo conditions has been frequently observed. The aim of this study was to examine whether placebo-induced chest pain improvement could be the result of changes in coronary blood flow. We, therefore, performed an experiment to investigate whether a verbal suggestion (VS) integrated in a cardiologic procedure has an impact on diameters of coronary arteries.

Methods: A total of 30 chest pain patients with normal diagnostic angiograms were assigned to a VS or a control group (CG). Saline solution was administered intracoronarily to both groups. The VS group received a standardized VS, implying coronary vasodilation. The CG remained without VS. Coronary end points were the changes in percentage diameter stenosis, Minimal lumen diameter and reference diameter of the index coronary segment before and 60 seconds after the administration of saline. Furthermore, changes in hemodynamics, psychological distress, and chest pain perception were recorded.

Results: The VS led to coronary vasoconstriction in comparison with CG (change in mean percentage diameter stenosis ± SD 3.2% ± 6.3% vs -1.7% ± 6.8%, P = .062; change in mean minimal lumen diameter ± SD -0.18 ± 0.32 mm vs 0.06 ± 0.23 mm, P = .029, no relevant change in the reference diameter). At the same time, the degree of chest pain perception was significantly reduced in the VS group (-0.7 ± 1.3) compared with the CG (0.3 ± 1.3), P = .024.

Conclusion: The findings of this study suggest that a VS results in a biological alteration within coronary arteries. Contrary to expectation, the VS led to vasoconstriction, whereas chest pain perception decreased.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Chest Pain / diagnostic imaging
  • Chest Pain / etiology
  • Chest Pain / psychology*
  • Coronary Angiography*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / etiology
  • Coronary Circulation / physiology*
  • Coronary Vessels / physiopathology*
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain Perception / physiology*
  • Retrospective Studies
  • Suggestion*
  • Vasoconstriction / physiology