Amygdalar activity may be an important predictor of cardiac events, according to a study published Jan. 11 in The Lancet.

Ahmed Tawakol, MD, et al., looked at 293 patients who were given a combined PET/CT scan to record their brain, bone marrow and spleen activity and inflammation of their arteries. The patients were then tracked for an average of 3.7 years to see if they developed cardiovascular disease. In this time 22 patients had cardiovascular events including heart attack, angina, heart failure, stroke and peripheral arterial disease. Those with higher amygdala activity had a greater risk of subsequent cardiovascular disease and developed problems sooner than those with lower activity.

In a smaller cross-sectional study, 13 patients who had a history of post-traumatic stress disorder (PTSD) also had their stress levels assessed by a psychologist, underwent a PET scan and had their levels of C-reactive protein measured. Those who reported the highest levels of stress had the highest levels of amygdala activity along with more signs of inflammation in their blood and the walls of their arteries.

Other research has also shown that the amygdala is more active in people with PTSD, anxiety and depression, but this is the first study to link regional brain activity to subsequent cardiovascular disease.

“Our results provide a unique insight into how stress may lead to cardiovascular disease. This raises the possibility that reducing stress could produce benefits that extend beyond an improved sense of psychological wellbeing,” said Tawakol. “Eventually, chronic stress could be treated as an important risk factor for cardiovascular disease, which is routinely screened for and effectively managed like other major cardiovascular disease risk factors.”

In an accompanying editorial comment, Ilze Bot, and Johan Kuiper, MD, explain that “In the past decade, more and more individuals experience psychosocial stress on a daily basis. Heavy workloads, job insecurity, or living in poverty are circumstances that can result in chronically increased stress, which in turn can lead to chronic psychological disorders such as depression.” They conclude that moving forward, more research is needed to confirm the mechanism.

Keywords: Heart Failure

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