York Kaki M, Hassan Mustafa, Sheps David S
VAMC, Psychology Service (116b), North Florida/South Georgia VA Healthcare System, 1601 SW Archer Rd, Gainesville, FL 32608, USA.
Heart Fail Rev. 2009 Mar;14(1):35-50. doi: 10.1007/s10741-008-9091-0. Epub 2008 Mar 27.
Heart failure affects millions of Americans and new diagnosis rates are expected to almost triple over the next 30 years as our population ages. Affective disorders including clinical depression and anxiety are common in patients with congestive heart failure. Furthermore, the presence of these disorders significantly impacts quality of life, medical outcomes, and healthcare service utilization. In recent years, the literature has attempted to describe potential pathophysiologic mechanisms relating affective disorders and psychosocial stress to heart failure. Several potential mechanisms have been proposed including autonomic nervous system dysfunction, inflammation, cardiac arrhythmias, and altered platelet function. These mechanisms are reviewed in this article. Additional novel mechanisms such as mental stress-induced myocardial ischemia are also discussed.
心力衰竭影响着数百万美国人，随着人口老龄化，预计在未来30年新诊断率将几乎增至三倍。包括临床抑郁症和焦虑症在内的情感障碍在充血性心力衰竭患者中很常见。此外，这些障碍的存在会显著影响生活质量、医疗结果和医疗服务利用情况。近年来，文献试图描述情感障碍和心理社会压力与心力衰竭相关的潜在病理生理机制。已经提出了几种潜在机制，包括自主神经系统功能障碍、炎症、心律失常和血小板功能改变。本文对这些机制进行了综述。还讨论了其他新机制，如精神压力诱发的心肌缺血。
