Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR 3053, Atlanta, GA 30322, United States; Department of Medicine, Division of Cardiology, Emory University School of Medicine, United States; Atlanta Veterans Affairs Healthcare System, Decatur, GA, United States.
Department of Psychiatry, Emory University School of Medicine, United States; Department of Anesthesiology, Feinberg School of Medicine, Northwestern University.
Trends Cardiovasc Med. 2022 Apr;32(3):172-177. doi: 10.1016/j.tcm.2021.03.001. Epub 2021 Mar 9.
Coronary heart disease and psychological stress factors such as depression are prevalent and associated with high morbidity/mortality; they are also challenging to manage, especially when treated in isolation of each other. Recent advances support an integrated approach to their management that is built on a foundation of an extensive, multi-component network of neurological structures. In this review, we describe this extensive cardioneural network that encompasses the heart, brain, spinal cord, and ganglia throughout the body, and then discuss ambulatory and laboratory-based non-invasive measures of this network that both measure psychological stress and heart disease severity. Lastly, we discuss their potential transformative clinical and public health applications, and also possible cardioneural interventions such as exercise and biofeedback.
冠心病和抑郁等心理应激因素普遍存在且与高发病率/死亡率相关;它们也难以治疗,尤其是在彼此孤立的情况下。最近的进展支持对它们进行综合管理的方法,该方法建立在广泛的、多成分的神经系统结构网络基础上。在这篇综述中,我们描述了这个广泛的心脏神经网络,它包含了心脏、大脑、脊髓和全身的神经节,然后讨论了这个网络的基于移动和实验室的非侵入性测量方法,这些方法既可以测量心理压力,也可以测量心脏病的严重程度。最后,我们讨论了它们在临床和公共卫生方面可能具有变革性的应用,以及可能的心脏神经干预措施,如运动和生物反馈。