Effects of a cognitive stress challenge on myocardial perfusion and plasma cortisol in coronary heart disease patients with depression.

Stress and Health : Journal of the International Society for the Investigation of Stress
James Douglas BremnerViola Vaccarino

Abstract

Although it is well established that coronary heart disease (CHD) patients with depression exhibit increased mortality compared with equally ill cardiac patients without depression, the mechanisms mediating this effect remain obscure. Depression is characterized by vulnerability to stress and heightened stress responsiveness, and stress can theoretically act through several biological pathways to contribute to excess mortality from CHD. Mechanisms connecting stress, depression and cardiovascular mortality have not been previously explored in detail. The purpose of this study was to assess the effects of stress and depression on myocardial perfusion and plasma cortisol concentrations in CHD patients. Patients with CHD with and without depression (n = 28) underwent single photon emission computed tomography imaging of myocardial perfusion at rest and during a stressful cognitive challenge. Severity of ischaemia was measured by summing perfusion defect scores across myocardial segments and subtracting out rest from stress scores. Plasma cortisol concentrations were measured at baseline and in response to the stressful challenge. There were no differences in stress-induced myocardial ischaemia or plasma cortisol response to stress ...Continue Reading

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Citations

May 26, 2018·Psychosomatic Medicine·J Douglas BremnerViola Vaccarino
Feb 25, 2020·The Journal of Nervous and Mental Disease·J Douglas BremnerViola Vaccarino

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