Fatigue, Anhedonia and Cardiac Prognostic Markers in Depressed Patients with Coronary Heart Disease

冠心病抑郁患者的疲劳、快感缺乏和心脏预后标志物

基本信息

  • 批准号:
    10171891
  • 负责人:
  • 金额:
    $ 74.5万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2020
  • 资助国家:
    美国
  • 起止时间:
    2020-06-01 至 2025-05-31
  • 项目状态:
    未结题

项目摘要

Depression is associated with an increased risk of cardiac morbidity and mortality in coronary heart disease (CHD). Although safe and modestly effective treatments for major depression exist, only about 30% of patients ever achieve full remission. CHD patients with depression symptoms that do not respond to treatment are at high risk for cardiac morbidity and mortality compared to those whose depression symptoms respond to treatment. Anhedonia and fatigue are among the most common symptoms to remain following treatment in both depressed CHD patients and in medically well psychiatric patients. In a recent study, we found that several risk markers of cardiovascular morbidity and mortality including a high normal level of the thyroid hormone free thyroxine (FT4), low nocturnal heart rate variability, blunted circadian heart rate, and poor sleep quality predict depression treatment response and post-treatment symptoms of fatigue and anhedonia. It is unclear why these risk markers are associated with residual anhedonia and fatigue. Elevated cortisol levels, chronic sympathetic nervous system activation, reduced vagal modulation of HR, high levels of perceived stress, low level of physical activity, disordered sleep, and occult subclinical thyroid diseases are among the most plausible explanations. Any or all of these factors may explain the relationship between the risk markers and residual fatigue and anhedonia, and all are potentially modifiable and thus possible targets for future clinical trials. The purpose of the proposed research is to identify modifiable correlates of these risk markers and of fatigue and anhedonia in depressed patients with CHD. Study participants will be recruited from cardiology practices at Washington University School of Medicine. Potentially eligible patients will be scheduled for a structured clinical interview. Those who score >14 on the BDI-II and meet the DSM-5 criteria for major depression and no exclusion criteria will be enrolled. Participants will be evaluated at the Behavioral Medicine Center at Washington University School of Medicine. The evaluation will be performed in the morning after a 12-hour fast, and will start with a blood draw to obtain a thyroid panel, lipid profile, plasma cortisol, C-reactive protein, and other biomarkers. Participants will be fitted with an ambulatory ECG monitor and a wrist actigraph, complete a battery of self-report inventories, and be given instructions for collecting saliva samples at home for cortisol measurement. The ECG monitor and actigraph will be worn for 48 hours on two consecutive weekdays to measure the ECG markers, activity levels, and sleep parameters. Saliva samples will be obtained three times per day for two days: upon awakening, mid-afternoon, and before bedtime. Participants will be compensated for their time upon return of the samples and equipment. This study will identify potential targets for adjunctive interventions to augment traditional depression treatments and thereby help to lay the groundwork for a randomized clinical trial to determine whether treating depression in patients with CHD can improve both depression and event-free survival.
抑郁症与冠心病的心脏病发病率和死亡率风险增加有关 (冠心病)。尽管存在针对重度抑郁症的安全且适度有效的治疗方法,但只有约 30% 的患者 曾经达到完全缓解。患有抑郁症状且对治疗无反应的先心病患者 与抑郁症状有反应的人相比,心脏病发病率和死亡率的风险较高 治疗。快感缺乏和疲劳是治疗后最常见的症状之一 抑郁的冠心病患者和健康状况良好的精神病患者。在最近的一项研究中,我们发现 心血管发病率和死亡率的几个风险标志物,包括甲状腺的正常高水平 无激素甲状腺素 (FT4)、夜间心率变异性低、昼夜节律心率迟缓和睡眠质量差 质量预测抑郁症治疗反应以及治疗后疲劳和快感缺乏症状。这是 尚不清楚为什么这些风险标记与残留的快感缺乏和疲劳有关。皮质醇水平升高, 慢性交感神经系统激活、心率迷走神经调节减少、感知水平高 压力、体力活动水平低、睡眠紊乱和隐匿性亚临床甲状腺疾病等 最合理的解释。任何或所有这些因素都可以解释风险标记之间的关系 以及残余疲劳和快感缺乏,所有这些都是潜在可改变的,因此是未来的可能目标 临床试验。拟议研究的目的是确定这些风险标记的可修改相关性 以及患有冠心病的抑郁症患者的疲劳和快感缺乏。研究参与者将从 华盛顿大学医学院的心脏病学实践。潜在符合资格的患者将 安排进行结构化临床访谈。 BDI-II 得分 >14 并符合 DSM-5 标准的人 对于重度抑郁症,不会纳入排除标准。参与者将在行为测试中接受评估 华盛顿大学医学院医学中心。评估将在 禁食 12 小时后的早晨,首先进行抽血以获取甲状腺指标、血脂、血浆 皮质醇、C 反应蛋白和其他生物标志物。参与者将配备动态心电图监护仪 和腕部活动记录仪,完成一系列自我报告清单,并获得收集指示 在家中采集唾液样本用于皮质醇测量。心电图监护仪和体动记录仪将佩戴 48 小时 连续两个工作日测量心电图标记、活动水平和睡眠参数。唾液 两天内每天采集三次样本:醒来时、下午三点左右和之前 就寝时间。参与者将在归还样品和设备后获得时间补偿。这项研究 将确定辅助干预措施的潜在目标,以增强传统抑郁症治疗的效果, 从而有助于为随机临床试验奠定基础,以确定是否可以治疗抑郁症 冠心病患者可以改善抑郁症和无事件生存期。

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

ROBERT M CARNEY其他文献

ROBERT M CARNEY的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('ROBERT M CARNEY', 18)}}的其他基金

Fatigue, Anhedonia and Cardiac Prognostic Markers in Depressed Patients with Coronary Heart Disease
冠心病抑郁患者的疲劳、快感缺乏和心脏预后标志物
  • 批准号:
    10411951
  • 财政年份:
    2020
  • 资助金额:
    $ 74.5万
  • 项目类别:
OMEGA-3 FOR DEPRESSION AND OTHER CARDIAC RISK FACTORS
OMEGA-3 针对抑郁症和其他心脏危险因素
  • 批准号:
    8787486
  • 财政年份:
    2014
  • 资助金额:
    $ 74.5万
  • 项目类别:
OMEGA-3 FOR DEPRESSION AND OTHER CARDIAC RISK FACTORS
OMEGA-3 针对抑郁症和其他心脏危险因素
  • 批准号:
    8988288
  • 财政年份:
    2014
  • 资助金额:
    $ 74.5万
  • 项目类别:
RANDOMIZED CONTROLLED TRIAL OF SCREENING FOR DEPRESSION IN CARDIAC OUTPATIENTS
心脏病门诊患者抑郁症筛查的随机对照试验
  • 批准号:
    8698763
  • 财政年份:
    2011
  • 资助金额:
    $ 74.5万
  • 项目类别:
RANDOMIZED CONTROLLED TRIAL OF SCREENING FOR DEPRESSION IN CARDIAC OUTPATIENTS
心脏病门诊患者抑郁症筛查的随机对照试验
  • 批准号:
    8305973
  • 财政年份:
    2011
  • 资助金额:
    $ 74.5万
  • 项目类别:
RANDOMIZED CONTROLLED TRIAL OF SCREENING FOR DEPRESSION IN CARDIAC OUTPATIENTS
心脏病门诊患者抑郁症筛查的随机对照试验
  • 批准号:
    8098552
  • 财政年份:
    2011
  • 资助金额:
    $ 74.5万
  • 项目类别:
RANDOMIZED CONTROLLED TRIAL OF SCREENING FOR DEPRESSION IN CARDIAC OUTPATIENTS
心脏病门诊患者抑郁症筛查的随机对照试验
  • 批准号:
    8479332
  • 财政年份:
    2011
  • 资助金额:
    $ 74.5万
  • 项目类别:
CARDIAC RISK MARKERS AND UNREMITTING DEPRESSION IN ACUTE CORONARY SYNDROME
急性冠脉综合征中的心脏风险标志物和持续抑郁
  • 批准号:
    8054977
  • 财政年份:
    2009
  • 资助金额:
    $ 74.5万
  • 项目类别:
CARDIAC RISK MARKERS AND UNREMITTING DEPRESSION IN ACUTE CORONARY SYNDROME
急性冠脉综合征中的心脏风险标志物和持续抑郁
  • 批准号:
    7769472
  • 财政年份:
    2009
  • 资助金额:
    $ 74.5万
  • 项目类别:
CARDIAC RISK MARKERS AND UNREMITTING DEPRESSION IN ACUTE CORONARY SYNDROME
急性冠脉综合征中的心脏风险标志物和持续抑郁
  • 批准号:
    8266006
  • 财政年份:
    2009
  • 资助金额:
    $ 74.5万
  • 项目类别:

相似海外基金

Childhood trauma, hippocampal function, and anhedonia among those at heightened risk for psychosis
精神病高危人群中的童年创伤、海马功能和快感缺失
  • 批准号:
    10825287
  • 财政年份:
    2024
  • 资助金额:
    $ 74.5万
  • 项目类别:
DNAメチル化障害とその量的形質遺伝子座を用いたanhedonia/dysphoria問題への接近
利用 DNA 甲基化障碍及其数量性状基因座解决快感缺乏/烦躁不安问题
  • 批准号:
    24K02698
  • 财政年份:
    2024
  • 资助金额:
    $ 74.5万
  • 项目类别:
    Grant-in-Aid for Scientific Research (B)
Testing a Memory-Based Hypothesis for Anhedonia
测试基于记忆的快感缺失假设
  • 批准号:
    10598974
  • 财政年份:
    2023
  • 资助金额:
    $ 74.5万
  • 项目类别:
Reward Responsiveness as a Prevention Target in Youth At Risk for Anhedonia
将奖励反应作为快感缺失风险青少年的预防目标
  • 批准号:
    10722481
  • 财政年份:
    2023
  • 资助金额:
    $ 74.5万
  • 项目类别:
Determining the role of social reward learning in social anhedonia in first-episode psychosis using motivational interviewing as a probe in a perturbation-based neuroimaging approach
使用动机访谈作为基于扰动的神经影像学方法的探索,确定社交奖励学习在首发精神病社交快感缺乏中的作用
  • 批准号:
    10594181
  • 财政年份:
    2023
  • 资助金额:
    $ 74.5万
  • 项目类别:
Mapping links between real-world diversity, positive emotion, and neural dynamics in anhedonia
映射现实世界多样性、积极情绪和快感缺失的神经动力学之间的联系
  • 批准号:
    10716446
  • 财政年份:
    2023
  • 资助金额:
    $ 74.5万
  • 项目类别:
Neural Circuit-Specific Mechanisms of Ketamine's Effect on Anhedonia and Anxiety in Depression Using Ultra-High Field 7-Tesla MRI
使用超高场 7 特斯拉 MRI 研究氯胺酮对抑郁症快感缺乏和焦虑影响的神经回路特异性机制
  • 批准号:
    10713827
  • 财政年份:
    2023
  • 资助金额:
    $ 74.5万
  • 项目类别:
Neuroinflammation as a Mechanism Linking Early Life Stress, Altered Functional Connectivity, and Anhedonia in Major Depression
神经炎症是一种与早期生活压力、功能连接改变和重度抑郁症快感缺失相关的机制
  • 批准号:
    10606174
  • 财政年份:
    2023
  • 资助金额:
    $ 74.5万
  • 项目类别:
Neurophysiological mechanisms of anhedonia and cognitive control deficits in trauma-exposed people completing vibroacoustically augmented breath focused mindfulness
创伤暴露人群完成振动声学增强呼吸聚焦正念的快感缺失和认知控制缺陷的神经生理机制
  • 批准号:
    10752342
  • 财政年份:
    2023
  • 资助金额:
    $ 74.5万
  • 项目类别:
Mechanisms of Depression and Anhedonia in Adolescents: Linking Sleep Duration and Timing to Reward- and Stress-Related Brain Function
青少年抑郁和快感缺失的机制:将睡眠持续时间和时间与奖励和压力相关的大脑功能联系起来
  • 批准号:
    10364517
  • 财政年份:
    2022
  • 资助金额:
    $ 74.5万
  • 项目类别:
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了