Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, Uttar Pradesh, India.
Biomed Pharmacother. 2017 Nov;95:487-496. doi: 10.1016/j.biopha.2017.08.109. Epub 2017 Sep 12.
Patient with myocardial infarction (MI) are often affected by psychological disorders such as depression, anxiety, and post-traumatic stress disorder. Psychological disorders are disabling and have a negative influence on recovery, reduce the quality of life and causes high mortality rate in MI patients. Despite tremendous advancement in technologies, screening scales, and treatment strategies, psychological sequelae of MI are currently understudied, underestimated, underdiagnosed, and undertreated. Depression is highly prevalent in MI patients followed by anxiety and post-traumatic stress disorder. Pathophysiological factors involved in psychopathologies observed in patients with MI are sympathetic over-activity, hypothalamic-pituitary-adrenal axis dysfunction, and inflammation. Numerous preclinical and clinical studies evidenced a positive association between MI and psychopathologies with a common molecular pathophysiology. This review provides an update on diagnostic feature, prevalence, pathophysiology, clinical outcomes, and management strategies of psychopathologies associated with MI. Moreover, preclinical research findings on molecular mechanisms involved in post-MI psychopathologies and future therapeutic strategies have been outlined in the review.
心肌梗死 (MI) 患者常受到抑郁、焦虑和创伤后应激障碍等心理障碍的影响。心理障碍会导致残疾,并对恢复产生负面影响,降低 MI 患者的生活质量并导致高死亡率。尽管在技术、筛查量表和治疗策略方面取得了巨大进展,但 MI 的心理后遗症目前研究不足、低估、诊断不足和治疗不足。MI 患者中抑郁的患病率很高,其次是焦虑和创伤后应激障碍。MI 患者观察到的精神病理学中涉及的病理生理因素包括交感神经过度活动、下丘脑-垂体-肾上腺轴功能障碍和炎症。大量临床前和临床研究表明,MI 与精神病理学之间存在正相关关系,具有共同的分子病理生理学。本综述提供了与 MI 相关的精神病理学的诊断特征、患病率、病理生理学、临床结果和管理策略的最新信息。此外,本综述还概述了与 MI 后精神病理学相关的分子机制的临床前研究结果和未来的治疗策略。