Dal Lin Carlo, Marinova Mariela, Rubino Giorgio, Gola Elisabetta, Brocca Alessandra, Pantano Giorgia, Brugnolo Laura, Sarais Cristiano, Cucchini Umberto, Volpe Biancarosa, Cavalli Chiara, Bellio Maura, Fiorello Emilia, Scali Sofia, Plebani Mario, Iliceto Sabino, Tona Francesco
Department of Cardiac, Thoracic and Vascular Sciences, Padua University-Hospital, Via Giustiniani 2, 35100 Padua, Italy.
Department of Laboratory Medicine, University-Hospital, Via Giustiniani 2, 35100 Padua, Italy.
J Tradit Complement Med. 2017 May 29;8(1):150-163. doi: 10.1016/j.jtcme.2017.04.011. eCollection 2018 Jan.
Mental stress is one of the main risk factors for cardiovascular disease. Meditation and music listening are two techniques that are able to counteract it through the activation of specific brain areas, eliciting the so-called Relaxing Response (RR). Epidemiological evidence reveals that the RR practice has a beneficial prognostic impact on patients after myocardial infarction. We aimed to study the possible molecular mechanisms of RR underlying these findings.
We enrolled 30 consecutive patients after myocardial infarction and 10 healthy controls. 10 patients were taught to meditate, 10 to appreciate music and 10 did not carry out any intervention and served as controls. After training, and after 60 days of RR practice, we studied the individual variations, before and after the relaxation sessions, of the vital signs, the electrocardiographic and echocardiographic parameters along with coronary flow reserve (CFR) and the carotid's intima media thickness (IMT). Neuro-endocrine-immune (NEI) messengers and the expression of inflammatory genes (p53, Nuclear factor Kappa B (NfKB), and toll like receptor 4 (TLR4)) in circulating peripheral blood mononuclear cells were also all observed.
The RR results in a reduction of NEI molecules (p < 0.05) and oxidative stress (p < 0.001). The expression of the genes p53, NFkB and TLR4 is reduced after the RR and also at 60 days (p < 0.001). The CFR increases with the relaxation (p < 0.001) and the IMT regressed significantly (p < 0.001) after 6 months of RR practice.
The RR helps to advantageously modulate the expression of inflammatory genes through a cascade of NEI messengers improving, over time, microvascular function and the arteriosclerotic process.
精神压力是心血管疾病的主要危险因素之一。冥想和听音乐是两种能够通过激活特定脑区来对抗精神压力的技巧，从而引发所谓的放松反应（RR）。流行病学证据表明，RR练习对心肌梗死后的患者具有有益的预后影响。我们旨在研究这些发现背后RR可能的分子机制。
我们招募了30例连续的心肌梗死后患者和10名健康对照者。10例患者被教导进行冥想，10例欣赏音乐，10例不进行任何干预作为对照。训练后，以及RR练习60天后，我们研究了放松前后生命体征、心电图和超声心动图参数以及冠状动脉血流储备（CFR）和颈动脉内膜中层厚度（IMT）的个体变化。还观察了循环外周血单核细胞中的神经内分泌免疫（NEI）信使以及炎症基因（p53、核因子κB（NfKB）和Toll样受体4（TLR4））的表达。
RR导致NEI分子减少（p<0.05）和氧化应激降低（p<0.001）。RR后以及60天时，基因p53、NFkB和TLR4的表达均降低（p<0.001）。RR练习后，CFR随放松而增加（p<0.001），IMT在6个月后显著消退（p<0.001）。
RR有助于通过一系列NEI信使有利地调节炎症基因的表达，随着时间的推移改善微血管功能和动脉硬化进程。
