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心肌梗死后抑郁的病理生理机制:一项叙述性综述

Pathophysiological mechanisms of post-myocardial infarction depression: a narrative review.

作者信息

Garrels Eric, Kainth Tejasvi, Silva Briana, Yadav Garima, Gill Gurtej, Salehi Mona, Gunturu Sasidhar

机构信息

Department of Psychiatry, BronxCare Health System, New York, NY, United States.

BronxCare Health System, New York, NY, United States.

出版信息

Front Psychiatry. 2023 Aug 4;14:1225794. doi: 10.3389/fpsyt.2023.1225794. eCollection 2023.

Abstract

Myocardial infarction (MI) can have significant physical and mental consequences. Depression is a prevalent psychiatric condition after MI which can reduce the quality of life and increase the mortality rates of patients. However, the connection between MI and depression has remained under-appreciated. This review examines the potential connection between depression and MI by overviewing the possible pathophysiologic mechanisms including dysregulation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, coagulation system dysfunction, inflammation, environmental factors, as well as, genetic factors. Furthermore, depression can be an adverse event of medications used for MI treatment including beta-blockers, statins, or anti-platelet agents. The need for early detection and management of depression in patients with MI is, therefore, crucial for improving their overall prognosis. Adherence to treatments and regular follow-up visits can ensure the best response to treatment.

摘要

心肌梗死(MI)会产生重大的身心后果。抑郁症是心肌梗死后普遍存在的一种精神疾病,它会降低患者的生活质量并增加死亡率。然而,心肌梗死与抑郁症之间的联系一直未得到充分重视。本综述通过概述可能的病理生理机制,包括下丘脑 - 垂体 - 肾上腺轴和自主神经系统的失调、凝血系统功能障碍、炎症、环境因素以及遗传因素,来探讨抑郁症与心肌梗死之间的潜在联系。此外,抑郁症可能是用于心肌梗死治疗的药物(包括β受体阻滞剂、他汀类药物或抗血小板药物)的不良事件。因此,对心肌梗死患者进行抑郁症的早期检测和管理对于改善其总体预后至关重要。坚持治疗和定期随访可以确保对治疗的最佳反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d293/10436342/f8f99a34538d/fpsyt-14-1225794-g001.jpg

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