A Pilot Study of Neurobiological Mechanisms of Stress and Cardiovascular Risk.

Autor:	Bremner JD; Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA.; Department Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.; Atlanta VA Medical Center, Decatur, GA, USA., Piccinelli M; Department Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA., Garcia EV; Department Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA., Moncayo VM; Department Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA., Elon L; Department of Epidemiology, Emory University, Atlanta, GA, USA., Nye JA; Department Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA., Cooke CD; Department Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA., Washington BP; Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA., Ortega RA; Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA., Desai SR; Department Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA., Okoh AK; Department Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA., Cheung B; Department Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA., Soyebo BO; Department of Epidemiology, Emory University, Atlanta, GA, USA., Shallenberger LH; Department of Epidemiology, Emory University, Atlanta, GA, USA., Raggi P; Mazankowski Alberta Heart Institute and the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada., Shah AJ; Department Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA.; Department of Epidemiology, Emory University, Atlanta, GA, USA.; Atlanta VA Medical Center, Decatur, GA, USA., Daaboul O; Department of Epidemiology, Emory University, Atlanta, GA, USA., Jajeh MN; Department of Epidemiology, Emory University, Atlanta, GA, USA., Ziegler C; Department of Epidemiology, Emory University, Atlanta, GA, USA., Driggers EG; Department of Epidemiology, Emory University, Atlanta, GA, USA., Murrah N; Department of Epidemiology, Emory University, Atlanta, GA, USA., De Cecco CN; Department Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.; Department Biomedical Informatics, Emory University School of Medicine, Atlanta, GA., van Assen M; Department Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA., Krafty RT; Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA., Quyyumi AA; Department Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA., Vaccarino V; Department Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA.; Department of Epidemiology, Emory University, Atlanta, GA, USA.
Jazyk:	angličtina
Zdroj:	Medical research archives [Med Res Arch] 2023 Apr; Vol. 11 (4). Date of Electronic Publication: 2023 Apr 25.
DOI:	10.18103/mra.v11i4.3787
Abstrakt:	Objective: Coronary heart disease is a leading cause of death and disability. Although psychological stress has been identified as an important potential contributor, mechanisms by which stress increases risk of heart disease and mortality are not fully understood. The purpose of this study was to assess mechanisms by which stress acts through the brain and heart to confer increased CHD risk. Methods: Coronary Heart Disease patients (N=10) underwent cardiac imaging with [Tc-99m] sestamibi single photon emission tomography at rest and during a public speaking mental stress task. Patients returned for a second day and underwent positron emission tomography imaging of the brain, heart, bone marrow, aorta (indicating inflammation) and subcutaneous adipose tissue, after injection of [ 18 F]2-fluoro-2-deoxyglucose for assessment of glucose uptake followed mental stress. Patients with (N=4) and without (N=6) mental stress-induced myocardial ischemia were compared for glucose uptake in brain, heart, adipose tissue and aorta with mental stress. Results: Patients with mental stress-induced ischemia showed a pattern of increased uptake in the heart, medial prefrontal cortex, and adipose tissue with stress. In the heart disease group as a whole, activity increase with stress in the medial prefrontal brain and amygdala correlated with stress-induced increases in spleen (r=0.69, p=0.038; and r=0.69, p=0.04 respectfully). Stress-induced frontal lobe increased uptake correlated with stress-induced aorta uptake (r=0.71, p=0.016). Activity in insula and medial prefrontal cortex was correlated with post-stress activity in bone marrow and adipose tissue. Activity in other brain areas not implicated in stress did not show similar correlations. Increases in medial prefrontal activity with stress correlated with increased cardiac glucose uptake with stress, suggestive of myocardial ischemia (r=0.85, p=0.004). Conclusions: These findings suggest a link between brain response to stress in key areas mediating emotion and peripheral organs involved in inflammation and hematopoietic activity, as well as myocardial ischemia, in Coronary Heart Disease patients. Competing Interests: Conflict: The authors have no conflicts of interest to declare in reference to this research.
Databáze:	MEDLINE
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