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Heart and brain interactions
Herz ( IF 1.1 ) Pub Date : 2021-02-05 , DOI: 10.1007/s00059-021-05022-5
Renate B. Schnabel , Gert Hasenfuß , Sylvia Buchmann , Kai G. Kahl , Stefanie Aeschbacher , Stefan Osswald , Christiane E. Angermann

Cardiovascular diseases (CVD) and mental health disorders (MHD; e.g. depression, anxiety and cognitive dysfunction) are highly prevalent and are associated with significant morbidity and mortality and impaired quality of life. Currently, possible interactions between pathophysiological mechanisms in MHD and CVD are rarely considered during the diagnostic work-up, prognostic assessment and treatment planning in patients with CVD, and research addressing bidirectional disease mechanisms in a systematic fashion is scarce. Besides some overarching pathogenetic principles shared by CVD and MHD, there are specific syndromes in which pre-existing neurological or psychiatric illness predisposes and contributes to CVD development (as in Takotsubo syndrome), or in which the distorted interplay between innate immune and central nervous systems and/or pre-existing CVD leads to secondary MHD and brain damage (as in peripartum cardiomyopathy or atrial fibrillation). Clinical manifestations and phenotypes of cardio-psycho-neurological diseases depend on the individual somatic, psychosocial, and genetic risk profile as well as on personal resilience, and differ in many respects between men and women. In this article, we provide arguments on why, in such conditions, multidisciplinary collaborations should be established to allow for more comprehensive understanding of the pathophysiology as well as appropriate and targeted diagnosis and treatment. In addition, we summarize current knowledge on the complex interactions between the cardiovascular and central nervous systems in Takotsubo syndrome and peripartum cardiomyopathy, and on the neurological and psychiatric complications of atrial fibrillation.



中文翻译:

心脏和大脑的相互作用

心血管疾病(CVD)和精神健康障碍(MHD;例如抑郁症,焦虑症和认知功能障碍)十分普遍,并与大量发病率和死亡率以及生活质量受损相关。目前,在CVD患者的诊断检查,预后评估和治疗计划期间,很少考虑MHD和CVD的病理生理机制之间可能存在的相互作用,并且缺乏以系统的方式解决双向疾病机制的研究。除了CVD和MHD共有的一些重要的致病原理外,还有一些特定的综合征,其中既有神经系统疾病或精神病性疾病易患并促进CVD的发展(例如Takotsubo综合征),或其中先天免疫和中枢神经系统之间相互作用的扭曲和/或预先存在的CVD导致继发性MHD和脑损伤(如围产期心肌病或心房颤动)。心血管神经神经疾病的临床表现和表型取决于个体的身体,心理和遗传风险状况以及个人的适应能力,并且在男女之间的许多方面都存在差异。在本文中,我们提供了有关在这种情况下为何应建立多学科合作以使人们对病理生理学以及适当和有针对性的诊断和治疗更为全面的理解的观点。此外,

更新日期:2021-02-05
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