Depressive illness and the heart: Identifying the relation between affective disorders and coronary heart disease

抑郁症与心脏：识别情感障碍与冠心病之间的关系

• 批准号: nhmrc : 225121
• 负责人: A/Pr Elisabeth Lambert
• 金额: $ 33.58万
• 依托单位: Baker IDI Heart and Diabetes Institute
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2003
• 资助国家: 澳大利亚
• 起止时间: 2003-01-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/depressive-illness-heart-heart-disease/96459
• 关键词: Depressive; illness; heart; Identifying; relation

Major depression is ranked fourth among the 10 leading causes of the global burden of disease and, if epidemiological projections are correct, by 2020 it will reach second place. Patients with depression are at increased risk of developing coronary heart disease. This elevated risk is independent of conventional risk factors such as smoking, obesity, hyperlipidaemia, diabetes and hypertension. Also conclusively demonstrated is the adverse effect of depression in patients following myocardial infarction (MI), which materially increases mortality. The mechanism of increased cardiac risk attributable to depressive illness is at present uncertain but activation of the sympathetic nervous system, exaggerated platelet reactivity and-or altered baroreflex function are likely to be of prime importance. Preliminary data from our laboratory indicates that whole body and cardiac sympathetic nervous activity and cardiac baroreflex sensitivity are modified following antidepressant therapy. Identifying the underlying neurochemical mechanisms responsible for alterations in affective behaviour, and quantifying cardiac and whole body sympathetic activity directly and indirectly, and testing whether therapeutic and behavioural interventions can influence brain neurotransmitter turnover and modify cardiac sympathetic tone, platelet reactivity, and baroreflex function in a fashion likely to reduce cardiac risk, will be an important step forward in alleviating the burden of depressive illness on the community.

重度抑郁症在全球疾病负担的十大主要原因中排名第四，如果流行病学预测正确，到 2020 年它将达到第二位。抑郁症患者患冠心病的风险增加。这种升高的风险与吸烟、肥胖、高脂血症、糖尿病和高血压等传统危险因素无关。还最终证明了抑郁症对心肌梗塞（MI）患者的不利影响，从而大大增加了死亡率。抑郁症导致心脏风险增加的机制目前尚不确定，但交感神经系统的激活、血小板反应性增强和/或压力反射功能改变可能是最重要的。我们实验室的初步数据表明，抗抑郁治疗后，全身和心脏交感神经活动以及心脏压力反射敏感性都会发生改变。确定导致情感行为改变的潜在神经化学机制，直接和间接量化心脏和全身交感神经活动，并测试治疗和行为干预是否可以影响大脑神经递质周转并以可能降低心脏风险的方式改变心脏交感张力、血小板反应性和压力反射功能，将是减轻抑郁症负担的重要一步 关于社区。