TY - JOUR
T1 - Common pathways and communication between the brain and heart
T2 - connecting post-traumatic stress disorder and heart failure
AU - Wilson, Marlene A.
AU - Liberzon, Israel
AU - Lindsey, Merry L.
AU - Lokshina, Yana
AU - Risbrough, Victoria B.
AU - Sah, Renu
AU - Wood, Susan K.
AU - Williamson, John B.
AU - Spinale, Francis G.
N1 - Funding Information:
Israel Liberzon – no COI to report. Government grants NIH, DoD, foundation grants – Cohen Veterans Bioscience, Industry – Sunovion Inc, ARMGO Pharm. Inc. None is related to cardiovascular/PTSD comorbidity. Other authors (MAW, MLL, YL, VBR, RS, SKW, JBW, FGS) have no disclosures to report.
Funding Information:
Investigators supported by funding from the Veterans Health Administration (VA: BX001374, BX001804, BX002664, BX000505, BX004312, BX001075, BX000168) and National Institutes of Health (NIH: HL075360, HL129823, HL137319, AA026560, MH113892; HL130972). Support to MAW from VA Merit Awards BX001374, BX001804 and BX002664. Support to MLL from VA Merit Award BX000505 and from NIH HL075360, HL129823, and HL137319. Support to VBR by VA Merit Award BX004312, NIAAA AA026560 and the VA Center of Excellence for Stress and Mental Health. Support to RS from VA Merit award BX001075. Support to SKW from VA Awards BX002664 and BX001374, NIH MH113892, and American Heart Association 15SDG224300017. Support to FS from VA Merit BX000168 and NIH HL130972. Support for the meeting provided through a BLRD Veterans Administration Field Meeting Proposal awarded to the William Jennings Bryan Dorn VA Medicine Center (now the Columbia VA Health Care System, Columbia, SC). We would like to thank Dr. Victoria Macht Preston for constructing the figure. Support for the meeting provided through a BLRD Veterans Administration Field Meeting Proposal awarded to the William Jennings Bryan Dorn VA Medicine Center (now the Columbia VA Health Care System, Columbia, SC). Importantly for the field, many similar recommendations were recently posted from a workshop on “The Cardiovascular Consequences of Post-Traumatic Stress Disorder,” sponsored by the National Heart, Lung, and Blood Institute (NHLBI) in Bethesda, Maryland from November 13-14, 2018. See: https://www.nhlbi.nih.gov/events/2018/nhlbi-working-group-cardiovascular-consequences-post-traumatic-stress-disorder
Publisher Copyright:
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019
Y1 - 2019
N2 - Psychiatric illnesses and cardiovascular disease (CVD) contribute to significant overall morbidity, mortality, and health care costs, and are predicted to reach epidemic proportions with the aging population. Within the Veterans Administration (VA) health care system, psychiatric illnesses such as post-traumatic stress disorder (PTSD) and CVD such as heart failure (HF), are leading causes of hospital admissions, prolonged hospital stays, and resource utilization. Numerous studies have demonstrated associations between PTSD symptoms and CVD endpoints, particularly in the Veteran population. Not only does PTSD increase the risk of HF, but this relationship is bi-directional. Accordingly, a VA-sponsored conference entitled “Cardiovascular Comorbidities in PTSD: The Brain-Heart Consortium” was convened to explore potential relationships and common biological pathways between PTSD and HF. The conference was framed around the hypothesis that specific common systems are dysregulated in both PTSD and HF, resulting in a synergistic acceleration and amplification of both disease processes. The conference was not intended to identify all independent pathways that give rise to PTSD and HF, but rather identify shared systems, pathways, and biological mediators that would be modifiable in both disease processes. The results from this conference identified specific endocrine, autonomic, immune, structural, genetic, and physiological changes that may contribute to shared PTSD-CVD pathophysiology and could represent unique opportunities to develop therapies for both PTSD and HF. Some recommendations from the group for future research opportunities are provided.
AB - Psychiatric illnesses and cardiovascular disease (CVD) contribute to significant overall morbidity, mortality, and health care costs, and are predicted to reach epidemic proportions with the aging population. Within the Veterans Administration (VA) health care system, psychiatric illnesses such as post-traumatic stress disorder (PTSD) and CVD such as heart failure (HF), are leading causes of hospital admissions, prolonged hospital stays, and resource utilization. Numerous studies have demonstrated associations between PTSD symptoms and CVD endpoints, particularly in the Veteran population. Not only does PTSD increase the risk of HF, but this relationship is bi-directional. Accordingly, a VA-sponsored conference entitled “Cardiovascular Comorbidities in PTSD: The Brain-Heart Consortium” was convened to explore potential relationships and common biological pathways between PTSD and HF. The conference was framed around the hypothesis that specific common systems are dysregulated in both PTSD and HF, resulting in a synergistic acceleration and amplification of both disease processes. The conference was not intended to identify all independent pathways that give rise to PTSD and HF, but rather identify shared systems, pathways, and biological mediators that would be modifiable in both disease processes. The results from this conference identified specific endocrine, autonomic, immune, structural, genetic, and physiological changes that may contribute to shared PTSD-CVD pathophysiology and could represent unique opportunities to develop therapies for both PTSD and HF. Some recommendations from the group for future research opportunities are provided.
KW - Post-traumatic stress disorder
KW - Veterans Affairs
KW - cardiovascular disease
KW - heart failure
KW - inflammation
KW - orexin/hypocretin
UR - http://www.scopus.com/inward/record.url?scp=85070905681&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85070905681&partnerID=8YFLogxK
U2 - 10.1080/10253890.2019.1621283
DO - 10.1080/10253890.2019.1621283
M3 - Review article
C2 - 31161843
AN - SCOPUS:85070905681
VL - 22
SP - 530
EP - 547
JO - Stress
JF - Stress
SN - 1025-3890
IS - 5
ER -