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Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study

Summary Background Emotional stress is associated with increased risk of cardiovascular disease. We imaged the amygdala, a brain region involved in stress, to determine whether its resting metabolic activity predicts risk of subsequent cardiovascular events. Methods Individuals aged 30 years or olde... Full description

Journal Title: The Lancet (British edition) 2017, Vol.389 (10071), p.834-845
Main Author: Tawakol, Ahmed, Dr
Other Authors: Ishai, Amorina, MD , Takx, Richard AP, MD , Figueroa, Amparo L, MD , Ali, Abdelrahman, MD , Kaiser, Yannick, BS , Truong, Quynh A, MD , Solomon, Chloe JE, BS , Calcagno, Claudia, MD , Mani, Venkatesh, PhD , Tang, Cheuk Y, PhD , Mulder, Willem JM, Prof , Murrough, James W, MD , Hoffmann, Udo, Prof , Nahrendorf, Matthias, MD , Shin, Lisa M, PhD , Fayad, Zahi A, Prof , Pitman, Roger K, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/28088338
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title: Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study
format: Article
creator:
  • Tawakol, Ahmed, Dr
  • Ishai, Amorina, MD
  • Takx, Richard AP, MD
  • Figueroa, Amparo L, MD
  • Ali, Abdelrahman, MD
  • Kaiser, Yannick, BS
  • Truong, Quynh A, MD
  • Solomon, Chloe JE, BS
  • Calcagno, Claudia, MD
  • Mani, Venkatesh, PhD
  • Tang, Cheuk Y, PhD
  • Mulder, Willem JM, Prof
  • Murrough, James W, MD
  • Hoffmann, Udo, Prof
  • Nahrendorf, Matthias, MD
  • Shin, Lisa M, PhD
  • Fayad, Zahi A, Prof
  • Pitman, Roger K, Prof
subjects:
  • Abridged Index Medicus
  • Aged
  • Amygdala - diagnostic imaging
  • Amygdala - metabolism
  • Analysis
  • Angina pectoris
  • Arteries - physiopathology
  • Atherosclerosis
  • Atherosclerosis - physiopathology
  • Bone marrow
  • Bone Marrow - metabolism
  • Cancer
  • Cardiology
  • Cardiovascular disease
  • Cardiovascular Diseases - diagnostic imaging
  • Cardiovascular Diseases - metabolism
  • Cardiovascular Diseases - psychology
  • Cross-Sectional Studies
  • Fluorodeoxyglucose F18
  • Health risk assessment
  • Hematopoiesis - physiology
  • Humans
  • Inflammation
  • Inflammation - physiopathology
  • Internal Medicine
  • Longitudinal Studies
  • Mediation
  • Medical research
  • Medical screening
  • Medicine, Experimental
  • Metabolism
  • Middle Aged
  • Perception
  • Positron Emission Tomography Computed Tomography
  • Radiopharmaceuticals
  • Risk Factors
  • Sport utility vehicles
  • Stress
  • Stress (Psychology)
  • Stress, Psychological - metabolism
  • Studies
ispartof: The Lancet (British edition), 2017, Vol.389 (10071), p.834-845
description: Summary Background Emotional stress is associated with increased risk of cardiovascular disease. We imaged the amygdala, a brain region involved in stress, to determine whether its resting metabolic activity predicts risk of subsequent cardiovascular events. Methods Individuals aged 30 years or older without known cardiovascular disease or active cancer disorders, who underwent18 F-fluorodexoyglucose PET/CT at Massachusetts General Hospital (Boston, MA, USA) between Jan 1, 2005, and Dec 31, 2008, were studied longitudinally. Amygdalar activity, bone-marrow activity, and arterial inflammation were assessed with validated methods. In a separate cross-sectional study we analysed the relation between perceived stress, amygdalar activity, arterial inflammation, and C-reactive protein. Image analyses and cardiovascular disease event adjudication were done by mutually blinded researchers. Relations between amygdalar activity and cardiovascular disease events were assessed with Cox models, log-rank tests, and mediation (path) analyses. Findings 293 patients (median age 55 years [IQR 45·0–65·5]) were included in the longitudinal study, 22 of whom had a cardiovascular disease event during median follow-up of 3·7 years (IQR 2·7–4·8). Amygdalar activity was associated with increased bone-marrow activity ( r =0·47; p
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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titleRelation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study
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creatorTawakol, Ahmed, Dr ; Ishai, Amorina, MD ; Takx, Richard AP, MD ; Figueroa, Amparo L, MD ; Ali, Abdelrahman, MD ; Kaiser, Yannick, BS ; Truong, Quynh A, MD ; Solomon, Chloe JE, BS ; Calcagno, Claudia, MD ; Mani, Venkatesh, PhD ; Tang, Cheuk Y, PhD ; Mulder, Willem JM, Prof ; Murrough, James W, MD ; Hoffmann, Udo, Prof ; Nahrendorf, Matthias, MD ; Shin, Lisa M, PhD ; Fayad, Zahi A, Prof ; Pitman, Roger K, Prof
creatorcontribTawakol, Ahmed, Dr ; Ishai, Amorina, MD ; Takx, Richard AP, MD ; Figueroa, Amparo L, MD ; Ali, Abdelrahman, MD ; Kaiser, Yannick, BS ; Truong, Quynh A, MD ; Solomon, Chloe JE, BS ; Calcagno, Claudia, MD ; Mani, Venkatesh, PhD ; Tang, Cheuk Y, PhD ; Mulder, Willem JM, Prof ; Murrough, James W, MD ; Hoffmann, Udo, Prof ; Nahrendorf, Matthias, MD ; Shin, Lisa M, PhD ; Fayad, Zahi A, Prof ; Pitman, Roger K, Prof
descriptionSummary Background Emotional stress is associated with increased risk of cardiovascular disease. We imaged the amygdala, a brain region involved in stress, to determine whether its resting metabolic activity predicts risk of subsequent cardiovascular events. Methods Individuals aged 30 years or older without known cardiovascular disease or active cancer disorders, who underwent18 F-fluorodexoyglucose PET/CT at Massachusetts General Hospital (Boston, MA, USA) between Jan 1, 2005, and Dec 31, 2008, were studied longitudinally. Amygdalar activity, bone-marrow activity, and arterial inflammation were assessed with validated methods. In a separate cross-sectional study we analysed the relation between perceived stress, amygdalar activity, arterial inflammation, and C-reactive protein. Image analyses and cardiovascular disease event adjudication were done by mutually blinded researchers. Relations between amygdalar activity and cardiovascular disease events were assessed with Cox models, log-rank tests, and mediation (path) analyses. Findings 293 patients (median age 55 years [IQR 45·0–65·5]) were included in the longitudinal study, 22 of whom had a cardiovascular disease event during median follow-up of 3·7 years (IQR 2·7–4·8). Amygdalar activity was associated with increased bone-marrow activity ( r =0·47; p<0·0001), arterial inflammation ( r =0·49; p<0·0001), and risk of cardiovascular disease events (standardised hazard ratio 1·59, 95% CI 1·27–1·98; p<0·0001), a finding that remained significant after multivariate adjustments. The association between amygdalar activity and cardiovascular disease events seemed to be mediated by increased bone-marrow activity and arterial inflammation in series. In the separate cross-sectional study of patients who underwent psychometric analysis (n=13), amygdalar activity was significantly associated with arterial inflammation ( r =0·70; p=0·0083). Perceived stress was associated with amygdalar activity ( r =0·56; p=0·0485), arterial inflammation ( r =0·59; p=0·0345), and C-reactive protein ( r =0·83; p=0·0210). Interpretation In this first study to link regional brain activity to subsequent cardiovascular disease, amygdalar activity independently and robustly predicted cardiovascular disease events. Amygdalar activity is involved partly via a path that includes increased bone-marrow activity and arterial inflammation. These findings provide novel insights into the mechanism through which emotional stressors can lead to cardiovascular disease in human beings. Funding None.
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languageeng
publisherEngland: Elsevier Ltd
subjectAbridged Index Medicus ; Aged ; Amygdala - diagnostic imaging ; Amygdala - metabolism ; Analysis ; Angina pectoris ; Arteries - physiopathology ; Atherosclerosis ; Atherosclerosis - physiopathology ; Bone marrow ; Bone Marrow - metabolism ; Cancer ; Cardiology ; Cardiovascular disease ; Cardiovascular Diseases - diagnostic imaging ; Cardiovascular Diseases - metabolism ; Cardiovascular Diseases - psychology ; Cross-Sectional Studies ; Fluorodeoxyglucose F18 ; Health risk assessment ; Hematopoiesis - physiology ; Humans ; Inflammation ; Inflammation - physiopathology ; Internal Medicine ; Longitudinal Studies ; Mediation ; Medical research ; Medical screening ; Medicine, Experimental ; Metabolism ; Middle Aged ; Perception ; Positron Emission Tomography Computed Tomography ; Radiopharmaceuticals ; Risk Factors ; Sport utility vehicles ; Stress ; Stress (Psychology) ; Stress, Psychological - metabolism ; Studies
ispartofThe Lancet (British edition), 2017, Vol.389 (10071), p.834-845
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6Truong, Quynh A, MD
7Solomon, Chloe JE, BS
8Calcagno, Claudia, MD
9Mani, Venkatesh, PhD
10Tang, Cheuk Y, PhD
11Mulder, Willem JM, Prof
12Murrough, James W, MD
13Hoffmann, Udo, Prof
14Nahrendorf, Matthias, MD
15Shin, Lisa M, PhD
16Fayad, Zahi A, Prof
17Pitman, Roger K, Prof
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0Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study
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descriptionSummary Background Emotional stress is associated with increased risk of cardiovascular disease. We imaged the amygdala, a brain region involved in stress, to determine whether its resting metabolic activity predicts risk of subsequent cardiovascular events. Methods Individuals aged 30 years or older without known cardiovascular disease or active cancer disorders, who underwent18 F-fluorodexoyglucose PET/CT at Massachusetts General Hospital (Boston, MA, USA) between Jan 1, 2005, and Dec 31, 2008, were studied longitudinally. Amygdalar activity, bone-marrow activity, and arterial inflammation were assessed with validated methods. In a separate cross-sectional study we analysed the relation between perceived stress, amygdalar activity, arterial inflammation, and C-reactive protein. Image analyses and cardiovascular disease event adjudication were done by mutually blinded researchers. Relations between amygdalar activity and cardiovascular disease events were assessed with Cox models, log-rank tests, and mediation (path) analyses. Findings 293 patients (median age 55 years [IQR 45·0–65·5]) were included in the longitudinal study, 22 of whom had a cardiovascular disease event during median follow-up of 3·7 years (IQR 2·7–4·8). Amygdalar activity was associated with increased bone-marrow activity ( r =0·47; p<0·0001), arterial inflammation ( r =0·49; p<0·0001), and risk of cardiovascular disease events (standardised hazard ratio 1·59, 95% CI 1·27–1·98; p<0·0001), a finding that remained significant after multivariate adjustments. The association between amygdalar activity and cardiovascular disease events seemed to be mediated by increased bone-marrow activity and arterial inflammation in series. In the separate cross-sectional study of patients who underwent psychometric analysis (n=13), amygdalar activity was significantly associated with arterial inflammation ( r =0·70; p=0·0083). Perceived stress was associated with amygdalar activity ( r =0·56; p=0·0485), arterial inflammation ( r =0·59; p=0·0345), and C-reactive protein ( r =0·83; p=0·0210). Interpretation In this first study to link regional brain activity to subsequent cardiovascular disease, amygdalar activity independently and robustly predicted cardiovascular disease events. Amygdalar activity is involved partly via a path that includes increased bone-marrow activity and arterial inflammation. These findings provide novel insights into the mechanism through which emotional stressors can lead to cardiovascular disease in human beings. Funding None.
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20Hematopoiesis - physiology
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22Inflammation
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24Internal Medicine
25Longitudinal Studies
26Mediation
27Medical research
28Medical screening
29Medicine, Experimental
30Metabolism
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32Perception
33Positron Emission Tomography Computed Tomography
34Radiopharmaceuticals
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12Murrough, James W, MD
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titleRelation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study
authorTawakol, Ahmed, Dr ; Ishai, Amorina, MD ; Takx, Richard AP, MD ; Figueroa, Amparo L, MD ; Ali, Abdelrahman, MD ; Kaiser, Yannick, BS ; Truong, Quynh A, MD ; Solomon, Chloe JE, BS ; Calcagno, Claudia, MD ; Mani, Venkatesh, PhD ; Tang, Cheuk Y, PhD ; Mulder, Willem JM, Prof ; Murrough, James W, MD ; Hoffmann, Udo, Prof ; Nahrendorf, Matthias, MD ; Shin, Lisa M, PhD ; Fayad, Zahi A, Prof ; Pitman, Roger K, Prof
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6Arteries - physiopathology
7Atherosclerosis
8Atherosclerosis - physiopathology
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11Cancer
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13Cardiovascular disease
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16Cardiovascular Diseases - psychology
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30Metabolism
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32Perception
33Positron Emission Tomography Computed Tomography
34Radiopharmaceuticals
35Risk Factors
36Sport utility vehicles
37Stress
38Stress (Psychology)
39Stress, Psychological - metabolism
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6Truong, Quynh A, MD
7Solomon, Chloe JE, BS
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abstractSummary Background Emotional stress is associated with increased risk of cardiovascular disease. We imaged the amygdala, a brain region involved in stress, to determine whether its resting metabolic activity predicts risk of subsequent cardiovascular events. Methods Individuals aged 30 years or older without known cardiovascular disease or active cancer disorders, who underwent18 F-fluorodexoyglucose PET/CT at Massachusetts General Hospital (Boston, MA, USA) between Jan 1, 2005, and Dec 31, 2008, were studied longitudinally. Amygdalar activity, bone-marrow activity, and arterial inflammation were assessed with validated methods. In a separate cross-sectional study we analysed the relation between perceived stress, amygdalar activity, arterial inflammation, and C-reactive protein. Image analyses and cardiovascular disease event adjudication were done by mutually blinded researchers. Relations between amygdalar activity and cardiovascular disease events were assessed with Cox models, log-rank tests, and mediation (path) analyses. Findings 293 patients (median age 55 years [IQR 45·0–65·5]) were included in the longitudinal study, 22 of whom had a cardiovascular disease event during median follow-up of 3·7 years (IQR 2·7–4·8). Amygdalar activity was associated with increased bone-marrow activity ( r =0·47; p<0·0001), arterial inflammation ( r =0·49; p<0·0001), and risk of cardiovascular disease events (standardised hazard ratio 1·59, 95% CI 1·27–1·98; p<0·0001), a finding that remained significant after multivariate adjustments. The association between amygdalar activity and cardiovascular disease events seemed to be mediated by increased bone-marrow activity and arterial inflammation in series. In the separate cross-sectional study of patients who underwent psychometric analysis (n=13), amygdalar activity was significantly associated with arterial inflammation ( r =0·70; p=0·0083). Perceived stress was associated with amygdalar activity ( r =0·56; p=0·0485), arterial inflammation ( r =0·59; p=0·0345), and C-reactive protein ( r =0·83; p=0·0210). Interpretation In this first study to link regional brain activity to subsequent cardiovascular disease, amygdalar activity independently and robustly predicted cardiovascular disease events. Amygdalar activity is involved partly via a path that includes increased bone-marrow activity and arterial inflammation. These findings provide novel insights into the mechanism through which emotional stressors can lead to cardiovascular disease in human beings. Funding None.
copEngland
pubElsevier Ltd
pmid28088338
doi10.1016/S0140-6736(16)31714-7
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