Key dimensions of post-traumatic stress disorder and endothelial dysfunction: a protocol for a mechanism-focused cohort study.
Key dimensions of post-traumatic stress disorder and endothelial dysfunction: a protocol for a mechanism-focused cohort study.
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DOI：
10.1136/bmjopen-2020-043060
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发表时间：
2021-05-05
期刊：
影响因子：
2.9
通讯作者：
Sumner JA
中科院分区：
文献类型：
--
作者：
Cleveland S;Reed K;Thomas JL;Ajijola OA;Ebrahimi R;Hsiai T;Lazarov A;Montoya AK;Neria Y;Shimbo D;Wolitzky-Taylor K;Sumner JA
创伤暴露和创伤后应激障碍（PTSD）都与心血管疾病（CVD）的风险增加有关，心血管疾病是美国死亡的主要原因。内皮功能障碍是一种可改变的心血管疾病风险的早期标志物，可能代表了这种相关性的生理机制。这项以机制为重点的队列研究旨在调查PTSD（诊断和潜在症状维度）与内皮功能障碍之间的关系，以社区为基础的成年男性和女性样本。采用队列设计，160名无CVD病史的创伤暴露参与者在基线诊断访谈评估后被指定为PTSD组（n=80）或创伤暴露匹配对照组（n=80）。PTSD组的参与者目前（过去一个月）有PTSD的诊断，而对照组的参与者有创伤史，但没有目前或过去的精神病诊断。通过肱动脉的流动介导的血管舒张和内皮细胞衍生的微粒的循环水平来评估内皮功能障碍。分别采用恐惧条件化范式和注意分配任务对PTSD的两个高阶症状维度-恐惧和焦虑进行了客观测量。自主神经失衡，炎症和氧化应激进行了额外的评估，并将作为潜在的通路变量连接PTSD及其尺寸与内皮功能障碍进行检查。邀请参与者返回进行2年随访，重新评估创伤后应激障碍及其维度和内皮功能障碍，以调查纵向相关性。本研究按照赫尔辛基宣言和加州大学洛杉矶机构审查委员会进行。这项研究的结果将通过同行评审期刊上的文章和学术会议上的演讲以及社区合作伙伴传播。NCT 03778307;预结果。
Both trauma exposure and post-traumatic stress disorder (PTSD) are associated with increased risk of cardiovascular disease (CVD), the leading cause of death in the USA. Endothelial dysfunction, a modifiable, early marker of CVD risk, may represent a physiological mechanism underlying this association. This mechanism-focused cohort study aims to investigate the relationship between PTSD (both in terms of diagnosis and underlying symptom dimensions) and endothelial dysfunction in a diverse, community-based sample of adult men and women. Using a cohort design, 160 trauma-exposed participants without a history of CVD are designated to the PTSD group (n=80) or trauma-exposed matched control group (n=80) after a baseline diagnostic interview assessment. Participants in the PTSD group have a current (past month) diagnosis of PTSD, whereas those in the control group have a history of trauma but no current or past psychiatric diagnoses. Endothelial dysfunction is assessed via flow-mediated vasodilation of the brachial artery and circulating levels of endothelial cell-derived microparticles. Two higher order symptom dimensions of PTSD—fear and dysphoria—are measured objectively with a fear conditioning paradigm and attention allocation task, respectively. Autonomic imbalance, inflammation, and oxidative stress are additionally assessed and will be examined as potential pathway variables linking PTSD and its dimensions with endothelial dysfunction. Participants are invited to return for a 2-year follow-up visit to reassess PTSD and its dimensions and endothelial dysfunction in order to investigate longitudinal associations. This study is conducted in compliance with the Helsinki Declaration and University of California, Los Angeles Institutional Review Board. The results of this study will be disseminated via articles in peer-reviewed journals and presentations at academic conferences and to community partners. NCT03778307; pre-results.
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