Powell-Wiley Tiffany M, Dey Amit K, Rivers Joshua P, Chaturvedi Abhishek, Andrews Marcus R, Ceasar Joniqua N, Claudel Sophie E, Mitchell Valerie M, Ayers Colby, Tamura Kosuke, Gutierrez-Huerta Cristhian A, Teague Heather L, Oeser Steffen G, Goyal Aditya, Joshi Aditya A, Collins Billy S, Baumer Yvonne, Chung Stephanie T, Sumner Anne E, Playford Martin P, Tawakol Ahmed, Mehta Nehal N
Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States.
Intramural Research Program, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health, Bethesda, MD, United States.
Front Cardiovasc Med. 2021 Mar 10;8:599341. doi: 10.3389/fcvm.2021.599341. eCollection 2021.
Psychosocial stress correlates with cardiovascular (CV) events; however, associations between physiologic measures of stressors and CVD remain incompletely understood, especially in racial/ethnic minority populations in resource-limited neighborhoods. We examined associations between chronic stress-related neural activity, measured by amygdalar Fluorodeoxyglucose (FDG) uptake, and aortic vascular FDG uptake (arterial inflammation measure) in a community-based cohort. Forty participants from the Washington, DC CV Health and Needs Assessment (DC-CHNA), a study of a predominantly African-American population in resource-limited urban areas and 25 healthy volunteers underwent detailed phenotyping, including FDG PET/CT for assessing amygdalar activity (AmygA), vascular FDG uptake, and hematopoietic (leukopoietic) tissue activity. Mediation analysis was used to test whether the link between AmygA and vascular FDG uptake was mediated by hematopoietic activity. AmygA (1.11 ± 0.09 vs. 1.05 ± 0.09, = 0.004) and vascular FDG uptake (1.63 ± 0.22 vs. 1.55 ± 0.17, = 0.05) were greater in the DC-CHNA cohort compared to volunteers. Within the DC-CHNA cohort, AmygA associated with vascular FDG uptake after adjustment for Framingham score and body mass index (β = 0.41, = 0.015). The AmygA and aortic vascular FDG uptake relationship was in part mediated by splenic (20.2%) and bone marrow (11.8%) activity. AmygA, or chronic stress-related neural activity, associates with subclinical CVD risk in a community-based cohort. This may in part be mediated by the hematopoietic system. Our findings of this hypothesis-generating study are suggestive of a potential relationship between chronic stress-related neural activity and subclinical CVD in an African American community-based population. Taken together, these findings suggest a potential mechanism by which chronic psychosocial stress, such as stressors that can be experienced in adverse social conditions, promotes greater cardiovascular risk amongst resource-limited, community-based populations most impacted by cardiovascular health disparities. However, larger prospective studies examining these findings in other racially and ethnically diverse populations are necessary to confirm and extend these findings.
心理社会压力与心血管（CV）事件相关；然而，应激源的生理指标与心血管疾病（CVD）之间的关联仍未完全明确，尤其是在资源有限社区的少数种族/族裔人群中。我们在一个社区队列中研究了通过杏仁核氟脱氧葡萄糖（FDG）摄取量测量的慢性应激相关神经活动与主动脉血管FDG摄取量（动脉炎症指标）之间的关联。来自华盛顿特区心血管健康与需求评估（DC-CHNA）的40名参与者（该研究主要针对资源有限城市地区的非裔美国人）和25名健康志愿者接受了详细的表型分析，包括使用FDG PET/CT评估杏仁核活动（AmygA）、血管FDG摄取量和造血（白细胞生成）组织活动。采用中介分析来检验AmygA与血管FDG摄取量之间的联系是否由造血活动介导。与志愿者相比，DC-CHNA队列中的AmygA（1.11±0.09 vs. 1.05±0.09，P = 0.004）和血管FDG摄取量（1.63±0.22 vs. 1.55±0.17，P = 0.05）更高。在DC-CHNA队列中，调整弗雷明汉评分和体重指数后，AmygA与血管FDG摄取量相关（β = 0.41，P = 0.015）。AmygA与主动脉血管FDG摄取量之间的关系部分由脾脏（20.2%）和骨髓（11.8%）活动介导。AmygA，即慢性应激相关神经活动，与社区队列中的亚临床CVD风险相关。这可能部分由造血系统介导。我们这项产生假设的研究结果提示了在以非裔美国人社区为基础的人群中慢性应激相关神经活动与亚临床CVD之间的潜在关系。综上所述，这些发现提示了一种潜在机制，即慢性心理社会压力，如在不利社会条件下可能经历的应激源，会在受心血管健康差异影响最大的资源有限的社区人群中增加更大的心血管风险。然而，需要在其他种族和族裔多样化人群中进行更大规模的前瞻性研究来证实和扩展这些发现。
