Tawseef Dar1,2, Azar Radfar1,2, Shady Abohashem1,2, Roger K Pitman3, Ahmed Tawakol1,2, Michael T Osborne4,5,6. 1. Cardiac MR-PET-CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. 2. Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, USA. 3. Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 4. Cardiac MR-PET-CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. mosborne@mgh.harvard.edu. 5. Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, USA. mosborne@mgh.harvard.edu. 6. Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA, 02114-2750, USA. mosborne@mgh.harvard.edu.
Abstract
PURPOSE OF REVIEW: This manuscript reviews the epidemiological data linking psychosocial stress to cardiovascular disease (CVD), describes recent advances in understanding the biological pathway between them, discusses potential therapies against stress-related CVD, and identifies future research directions. RECENT FINDINGS: Metabolic activity of the amygdala (a neural center that is critically involved in the response to stress) can be measured on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) yielding a neurobiological signal that independently predicts subsequent CVD events. Furthermore, a serial pathway from ↑amygdalar activity → ↑hematopoietic tissue activity → ↑arterial inflammation → ↑CVD events has been elucidated, providing new insights into the mechanism linking stress to CVD. Psychosocial stress and stress conditions are independently associated with CVD in a manner that depends on the degree and duration of stress as well as the individual response to a stressor. Nevertheless, the fundamental biology remains incompletely defined, and stress is often confounded by adverse health behaviors. Thus, most clinical guidelines do not yet recognize psychosocial stress as an independent CVD risk factor or advocate for its treatment in CVD prevention. Clarification of this neurobiological pathway provides a better understanding of the underlying pathophysiology and suggests opportunities to develop novel preventive strategies and therapies.
PURPOSE OF REVIEW: This manuscript reviews the epidemiological data linking psychosocial stress to cardiovascular disease (CVD), describes recent advances in understanding the biological pathway between them, discusses potential therapies against stress-related CVD, and identifies future research directions. RECENT FINDINGS: Metabolic activity of the amygdala (a neural center that is critically involved in the response to stress) can be measured on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) yielding a neurobiological signal that independently predicts subsequent CVD events. Furthermore, a serial pathway from ↑amygdalar activity → ↑hematopoietic tissue activity → ↑arterial inflammation → ↑CVD events has been elucidated, providing new insights into the mechanism linking stress to CVD. Psychosocial stress and stress conditions are independently associated with CVD in a manner that depends on the degree and duration of stress as well as the individual response to a stressor. Nevertheless, the fundamental biology remains incompletely defined, and stress is often confounded by adverse health behaviors. Thus, most clinical guidelines do not yet recognize psychosocial stress as an independent CVD risk factor or advocate for its treatment in CVD prevention. Clarification of this neurobiological pathway provides a better understanding of the underlying pathophysiology and suggests opportunities to develop novel preventive strategies and therapies.
Entities:
Keywords:
Amygdalar activity; Cardiovascular disease; PET imaging; Psychosocial stress
Authors: S M Schaefer; H C Abercrombie; K A Lindgren; C L Larson; R T Ward; T R Oakes; J E Holden; S B Perlman; P A Turski; R J Davidson Journal: Hum Brain Mapp Date: 2000-05 Impact factor: 5.038
Authors: W Jiang; J Alexander; E Christopher; M Kuchibhatla; L H Gaulden; M S Cuffe; M A Blazing; C Davenport; R M Califf; R R Krishnan; C M O'Connor Journal: Arch Intern Med Date: 2001 Aug 13-27
Authors: D M Manodhi K Saranapala; John Baranoff; R Louise Rushworth; Ian Westley; Kathryn Collins; Anne L J Burke; Andrea Parker; Julio Licinio; Peter M Clifton; David J Torpy Journal: Compr Psychoneuroendocrinol Date: 2022-02-09
Authors: Michael T Osborne; Lisa M Shin; Nehal N Mehta; Roger K Pitman; Zahi A Fayad; Ahmed Tawakol Journal: Circ Cardiovasc Imaging Date: 2020-08-14 Impact factor: 7.792
Authors: Tawseef Dar; Michael T Osborne; Shady Abohashem; Taimur Abbasi; Karmel W Choi; Ahmed Ghoneem; Nicki Naddaf; Jordan W Smoller; Roger K Pitman; John W Denninger; Lisa M Shin; Gregory Fricchione; Ahmed Tawakol Journal: Circ Cardiovasc Imaging Date: 2020-08-13 Impact factor: 7.792
Authors: Anthony S Zannas; Jennifer L Gordon; Alan L Hinderliter; Susan S Girdler; David R Rubinow Journal: J Clin Endocrinol Metab Date: 2020-10-01 Impact factor: 5.958
Authors: Azar Radfar; Shady Abohashem; Michael T Osborne; Ying Wang; Tawseef Dar; Malek Z O Hassan; Ahmed Ghoneem; Nicki Naddaf; Tomas Patrich; Taimur Abbasi; Hadil Zureigat; James Jaffer; Parastou Ghazi; James A Scott; Lisa M Shin; Roger K Pitman; Tomas G Neilan; Malissa J Wood; Ahmed Tawakol Journal: Eur Heart J Date: 2021-05-14 Impact factor: 35.855
Authors: Lulu Yao; Kun Cai; Fanghua Mei; Xiaohua Wang; Chuangang Fan; Hong Jiang; Fang Xie; Ying Li; Lu Bai; Kang Peng; Wenwen Deng; Shenghan Lai; Jun Wang Journal: Front Psychiatry Date: 2021-05-21 Impact factor: 4.157