Granville Smith Isabelle, Parker Gordon, Rourke Poppy, Cvejic Erin, Vollmer-Conna Uté
School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
Aust N Z J Psychiatry. 2015 Nov;49(11):994-1005. doi: 10.1177/0004867415597304. Epub 2015 Jul 28.
To examine the evidence for shared pathophysiological pathways in acute coronary syndrome and major depression and to conceptualise the dynamic interplay of biological systems and signalling pathways that link acute coronary syndrome and depression within a framework of neuro-visceral integration.
Relevant articles were sourced via a search of published literature from MEDLINE, EMBASE and PubMed using a variety of search terms relating to biological connections between acute coronary syndrome and depression. Additional articles from bibliographies of retrieved papers were assessed and included where relevant.
Despite considerable research efforts, a clear understanding of the biological processes connecting acute coronary syndrome and depression has not been achieved. Shared abnormalities are evident across the immune, platelet/endothelial and autonomic/stress-response systems. From the available evidence, it seems unlikely that a single explanatory model could account for the complex interactions of biological pathways driving the pathophysiology of these disorders and their comorbidity.
A broader conceptual framework of mind-body or neuro-visceral integration that can incorporate the existence of several causative scenarios may be more useful in directing future research and treatment approaches for acute coronary syndrome-associated depression.
研究急性冠状动脉综合征与重度抑郁症共享病理生理途径的证据，并在神经-内脏整合框架内，对连接急性冠状动脉综合征与抑郁症的生物系统和信号通路的动态相互作用进行概念化。
通过使用与急性冠状动脉综合征和抑郁症之间生物学联系相关的各种搜索词，在MEDLINE、EMBASE和PubMed的已发表文献中进行搜索，获取相关文章。对检索论文参考文献中的其他文章进行评估，并在相关时纳入。
尽管进行了大量研究，但尚未明确了解连接急性冠状动脉综合征和抑郁症的生物学过程。在免疫、血小板/内皮和自主神经/应激反应系统中，共享异常现象明显。从现有证据来看，单一的解释模型似乎无法解释驱动这些疾病及其合并症病理生理的生物途径的复杂相互作用。
一个更广泛的身心或神经-内脏整合概念框架，能够纳入多种致病情况，可能对指导未来急性冠状动脉综合征相关抑郁症的研究和治疗方法更有用。
