Background:
Psychological stress is a risk factor for major adverse cardiovascular events in individuals with coronary artery disease (CAD). Accelerated biological aging, as indicated by telomere shortening, is a recognized pathway by which stress may lead to cardiovascular disease incidence and mortality. We sought to investigate brain correlates of acute psychological stress and short telomeres in men and women with CAD.
Methods:
Individuals with CAD (N = 170) underwent a validated mental stress protocol including public speaking and mental arithmetic. Imaging of the brain with [O-15] water positron emission tomography (PET) was performed during mental stress and control conditions. Telomere length in peripheral leucocytes was measured by quantitative PCR and expressed as T/S-units. Voxel-wise regression models were constructed to assess the association between brain areas and activity during rest and mental stress after adjustments for demographic factors and clinical characteristics.
Methods:
The mean (SD) age was 62 (8) years, and 69% were men. The median telomere length was 0.84 T/S-units. Increased activation with mental stress in the lingual gyrus, cerebellum and superior and inferior gyrus in the frontal lobe were associated with reduced telomere length; 1.6 higher voxel activation of the inferior frontal gyrus was associated with 0.1 T/S-units reduction in telomere length (P < 0.005). Additionally, higher resting activities of the precentral, middle and superior frontal gyri and middle temporal gyri were associated with short telomeres. Results remained consistent after adjustment for demographic and clinical risk factors.
Conclusion:
Increased resting brain activity and reactivity to mental stress within the frontal lobe is associated with short telomeres. These frontal areas may regulate biological aging at rest and in connection with stress, which may contribute to cardiovascular vulnerability.
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