von Känel Roland
Kompetenzbereich für Psychosomatische Medizin, Klinik für Allgemeine Innere Medizin, Universitätsspital, Inselspital, Bern und Departement für Klinische Forschung, Universität Bern.
Praxis (Bern 1994). 2014 Jan 15;103(2):85-93. doi: 10.1024/1661-8157/a001515.
The prevalence of a major depressive disorder in patients after myocardial infarction is 20%. Depression is a risk factor for incident coronary heart disease and poor prognosis after myocardial infarction. Poor lifestyle habits and adherence to cardiac therapy as well as metabolic and pathophysiologic changes may partially explain this link. The threatening experience of an acute coronary event and immune and inflammatory changes may be unique features contributing to incident depression after myocardial infarction. While psychotherapy, antidepressants, and physical exercise may alleviate depressive symptoms in patients with coronary heart disease, cardiac rehabilitation additionally reduces mortality risk. Attempts are being undertaken to identify the cardiotoxic characteristics of depression to develop even more effective therapies in the future.
心肌梗死后患者中重度抑郁症的患病率为20%。抑郁症是冠心病发病和心肌梗死后预后不良的危险因素。不良的生活习惯、对心脏治疗的依从性以及代谢和病理生理变化可能部分解释了这种关联。急性冠状动脉事件的威胁性经历以及免疫和炎症变化可能是导致心肌梗死后新发抑郁症的独特因素。虽然心理治疗、抗抑郁药和体育锻炼可能会缓解冠心病患者的抑郁症状,但心脏康复还能降低死亡风险。目前正在努力确定抑郁症的心脏毒性特征,以便在未来开发出更有效的治疗方法。