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Autonomic Innervation of the Heart pp 419–435Cite as

Imaging the Functional Brain-Heart Axis: Mental Stress and Cardiac Dysfunction

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Abstract

Smoking, hypertension and diabetes mellitus are established risk factors for developing endothelial dysfunction and consequently atherosclerosis. Atherosclerosis can lead to myocardial ischemia, in response to physical exercise, change of temperature and emotional stress. Among forms of emotional stress, depression and anxiety are also associated with a higher incidence of coronary artery disease (CAD), as well as worse outcomes in patients with existing CAD. The best validated modalities for imaging myocardial ischemia are single-photon emission computed tomography (SPECT) and positron emission tomography (PET). Each imaging modality offers its own advantages. The exact pathophysiology of mental stress-induced myocardial ischemia is unclear. The cardiac-neural axis seems to play an important role, with special interest in the sympathetic nerve system and adrenomedullary hormones. This chapter describes the published literature using imaging techniques that address mental stress-induced ischemia and its relation to cardiac autonomic dysfunction. Non-invasive imaging of sympathetic and parasympathetic cardiac innervation remains a field for further exploration.

Disclosures

The authors declare not having received financial support.

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Abbreviations

ATP:

Adenosine triphosphate

CAD:

Coronary artery disease

CAG:

Coronary angiography

CT:

Computed tomography

DSM-V:

The Diagnostic and Statistical Manual of Mental Disorders (version 5)

ECG:

Electrocardiogram

HRV:

Heart rate variability

ICN:

Intracardiac neurons

LBD:

Lewy body disease

LDL:

Low-density lipoproteins

MI:

Myocardial infarction

MPI:

Myocardial perfusion imaging

MRI:

Magnetic resonance imaging

MVO2:

Myocardial oxygen consumption

OR:

Odds ratio

PET:

Positron emission tomography

PTSD:

Post-traumatic stress disorders

RPP:

Rate-pressure product

SPECT:

Single-photon emission computed tomography

TRPV:

Transient receptor potential vanilloid

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Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 30.001, 9700, Groningen, The Netherlands

    Walter Noordzij MD, Andor W. J. M. Glaudemans MD, PhD & Riemer H. J. A. Slart MD, PhD

  2. Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    René A. Tio MD, PhD & Mike J. L. DeJongste MD, PhD, FESC

  3. Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Hans C. Klein MD, PhD

Authors
  1. Walter Noordzij MD
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  2. Andor W. J. M. Glaudemans MD, PhD
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  3. René A. Tio MD, PhD
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  4. Mike J. L. DeJongste MD, PhD, FESC
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  5. Hans C. Klein MD, PhD
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  6. Riemer H. J. A. Slart MD, PhD
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Correspondence to Walter Noordzij MD .

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Editors and Affiliations

  1. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Riemer H.J.A. Slart

  2. Thorax center Cardiology, University Medical Center Groningen, Groningen, The Netherlands

    René A. Tio

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Philip H. Elsinga

  4. Nuklearmedizinische Klinik, Klinikum Rechts der Isar Technische Universität München, München, Germany

    Markus Schwaiger

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Noordzij, W., Glaudemans, A.W.J.M., Tio, R.A., DeJongste, M.J.L., Klein, H.C., Slart, R.H.J.A. (2015). Imaging the Functional Brain-Heart Axis: Mental Stress and Cardiac Dysfunction. In: Slart, R., Tio, R., Elsinga, P., Schwaiger, M. (eds) Autonomic Innervation of the Heart. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45074-1_22

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  • DOI: https://doi.org/10.1007/978-3-662-45074-1_22

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