Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China.
Physiol Behav. 2013 Jun 13;118:152-8. doi: 10.1016/j.physbeh.2013.05.024. Epub 2013 May 17.
Endothelial dysfunction has been considered as one of potential mechanisms by which depression and stress might contribute to the development of coronary artery disease (CAD). Recent studies suggest that circulating endothelial progenitor cells (EPCs) and brachial artery flow-mediated dilation (FMD) are related to endothelial function and progression of CAD. We investigated the relationships between the level of circulating CD34/KDR(+) EPCs and CD133/KDR(+) EPCs, brachial FMD, and scores of depression and stress measured with the Depression Anxiety Stress Scales in 288 stable angina patients without major psychiatric disorders. As defined by the ≥75th percentile, 100 (35%) subjects had high depression score (≥8), and 84 (29%) subjects had high stress score (≥10). Subjects with high depression or stress score had significantly lower FMD (1.86±0.14 vs. 3.63±0.17%, p<0.001; 2.05±0.18 vs. 3.48±0.17%, p<0.001) and percentage of circulating CD34/KDR(+) EPCs (0.97±0.11 vs. 1.94±0.17%, p<0.001; 1.09±0.13 vs. 1.68±0.16%, p=0.005), but not CD133/KDR(+) EPCs (0.52±0.04 vs. 0.66±0.06%, p=0.057; 0.61±0.05 vs. 0.59±0.05%, p=0.833), as compared with subjects with normal depression or stress score. Multivariate regression analysis indicated that high depression score (OR 1.09, 95% CI: 1.04-1.15, p<0.001), but not stress score or percentage of circulating EPCs, independently predicted impaired brachial FMD. In conclusions, our results demonstrated that in stable angina patients without major psychiatric disorders, a high depression or stress score was related to attenuated brachial FMD and depletion of circulating EPCs. However, only the depression score, but not the stress score or the level of EPCs, was an independent predictor for decreased brachial FMD.
内皮功能障碍被认为是抑郁和压力导致冠状动脉疾病（CAD）发展的潜在机制之一。最近的研究表明，循环内皮祖细胞（EPC）和肱动脉血流介导的扩张（FMD）与内皮功能和 CAD 的进展有关。我们研究了 288 例无重大精神疾病的稳定型心绞痛患者中，循环 CD34/KDR(+)EPC 和 CD133/KDR(+)EPC 水平、肱动脉 FMD 与抑郁和压力评分之间的关系，抑郁和压力评分采用抑郁焦虑应激量表进行测量。根据≥75%百分位数，100 例（35%）患者的抑郁评分较高（≥8），84 例（29%）患者的压力评分较高（≥10）。高抑郁或高压力评分的患者 FMD 明显较低（1.86±0.14 对 3.63±0.17%，p<0.001；2.05±0.18 对 3.48±0.17%，p<0.001），循环 CD34/KDR(+)EPC 百分比也较低（0.97±0.11 对 1.94±0.17%，p<0.001；1.09±0.13 对 1.68±0.16%，p=0.005），但 CD133/KDR(+)EPC 百分比无差异（0.52±0.04 对 0.66±0.06%，p=0.057；0.61±0.05 对 0.59±0.05%，p=0.833）。多变量回归分析表明，高抑郁评分（OR 1.09，95%CI：1.04-1.15，p<0.001），而非压力评分或循环 EPC 百分比，可独立预测肱动脉 FMD 受损。结论：在无重大精神疾病的稳定型心绞痛患者中，高抑郁或高压力评分与肱动脉 FMD 降低和循环 EPC 减少有关。然而，只有抑郁评分，而不是压力评分或 EPC 水平，是肱动脉 FMD 降低的独立预测因素。
