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A Pilot Study of Neurobiological Mechanisms of Stress and Cardiovascular Risk

J Douglas Bremner1,2,3, Marina Piccinelli2, Ernest V Garcia2

  • 1Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA.

Medical Research Archives
|July 24, 2023
PubMed

Insights

Psychological stress impacts the brain and heart, increasing coronary heart disease (CHD) risk. This study reveals how stress affects brain activity, inflammation, and myocardial ischemia in CHD patients.

Area of Science:

  • Cardiovascular Disease Research
  • Neuroscience
  • Medical Imaging

Background:

  • Coronary heart disease (CHD) is a major cause of mortality globally.
  • The precise mechanisms linking psychological stress to increased CHD risk and mortality remain incompletely understood.
  • Investigating the brain-heart axis in stress response is crucial for understanding CHD pathogenesis.

Purpose of the Study:

  • To elucidate the mechanisms by which psychological stress influences the brain and heart, thereby increasing CHD risk.
  • To assess the relationship between brain activity, peripheral organ function, and cardiac events under mental stress in CHD patients.

Main Methods:

  • Coronary Heart Disease patients (N=10) underwent cardiac imaging (SPECT) at rest and during mental stress.
  • Positron emission tomography (PET) with [18F]FDG was used to assess glucose uptake in the brain, heart, bone marrow, aorta, and adipose tissue.
  • Comparison of glucose uptake patterns between patients with and without mental stress-induced myocardial ischemia.

Main Results:

  • Patients with stress-induced ischemia exhibited increased glucose uptake in the heart, medial prefrontal cortex, and adipose tissue.
  • Stress-induced activity in the medial prefrontal cortex and amygdala correlated with spleen activity.
  • Increased medial prefrontal cortex activity correlated with heightened cardiac glucose uptake, indicating myocardial ischemia.

Conclusions:

  • A significant link exists between brain regions mediating emotional responses to stress and peripheral organs involved in inflammation and hematopoietic activity.
  • These findings highlight a potential pathway through which stress contributes to myocardial ischemia and adverse outcomes in CHD.
  • Understanding this brain-heart connection offers new avenues for managing stress-related cardiovascular risk.
Abstract

Keywords:
PTSDcardiovascular diseasedepressive disordersstress

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