Sex differences in the inflammatory response to stress and risk of adverse cardiovascular outcomes among patients with coronary heart disease

Sullivan, Samaah; Young, An; Hammadah, Muhammad; Lima, Bruno B; Levantsevych, Oleksiy; Ko, Yi‐An; Pearce, Brad D.; Shah, Amit; Kim, Jeong Hwan; Moazzami, Kasra; Driggers, Emily; Haffar, Ammer; Ward, Laura; Herring, Isaias; Hankus, Allison; Lewis, Tené T.; Mehta, Puja K.; Bremner, J. Douglas; Raggi, Paolo; Quyyumi, Arshed A.; Vaccarino, Viola

doi:10.1016/j.bbi.2020.09.001

Cited by 31 publications

(22 citation statements)

References 70 publications

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“…A major recent finding from our laboratory is that dynamic changes of vascular and immune function measures with mental stress are related to adverse patient outcomes independent of respective baseline (resting) levels and are often better predictors of adverse outcomes than resting levels. We have observed this pattern with transient endothelial dysfunction with mental stress measured by flow-mediated vasodilation (FMD) [20], with stress-induced peripheral vasoconstriction [25], and with the inflammatory response to mental stress (especially in women) [28]. Using positron emission tomography (PET) imaging of the brain, we have shown that mental stress-induced myocardial ischemia and peripheral vasoconstrictive responses to mental stress are related to activation in brain areas involved in the stress response, emotion and autonomic regulation of the cardiovascular system [27,41], and that activation of these areas is associated with cardiovascular outcomes [18], as well as with angina symptoms [42] and obesity [43] in patients with CVD.…”

Section: Overview Of Contributions Of Laboratory Research On Mental Stressmentioning

confidence: 89%

“…Over the past decade, we centered efforts on the effects of acute psychological stress as measured experimentally in the laboratory on cardiovascular physiology, immune function, myocardial ischemia, neurobiology and cardiovascular outcomes in men and women with CVD [18][19][20][21][22][23][24][25][26][27][28]. Others have also reported that acute mental stress is associated with abnormal coronary reactivity, plaque rupture, as well as cardiac arrhythmias [22,[29][30][31][32][33].…”

Section: Overview Of Contributions Of Laboratory Research On Mental Stressmentioning

confidence: 99%

“…Others have also reported that acute mental stress is associated with abnormal coronary reactivity, plaque rupture, as well as cardiac arrhythmias [22,[29][30][31][32][33]. We have developed the concept that stress and mental health are especially important in influencing cardiovascular outcomes in patient subgroups such as women, patients with an early-onset myocardial infarction (MI), and patients with adverse psychosocial exposures [19,23,24,26,28,[34][35][36]. A general conceptual framework is that chronic or cumulative stress causes dysregulation of adaptive stress response systems which, in turn, affect CVD risk though downstream effects on autonomic, vascular, immune, metabolic, injury and repair physiology; these effects are exacerbated by dynamic perturbations in response to everyday stressors or recurrent negative emotions (Fig.…”

Section: Overview Of Contributions Of Laboratory Research On Mental Stressmentioning

confidence: 99%

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Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient

et al. 2021

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The influence of psychological stress on the physiology of the cardiovascular system, and on the etiology and outcomes of cardiovascular disease (CVD) has been the object of intense investigation. As a whole, current knowledge points to a "brain-heart axis" that is especially important in individuals with pre-existing CVD. The use of acute psychological stress provocation in the laboratory has been useful to clarify the effects of psychological stress on cardiovascular physiology, immune function, vascular reactivity, myocardial ischemia, neurobiology and cardiovascular outcomes. An emerging paradigm is that dynamic perturbations of physiological and molecular pathways during stress or negative emotions are important in influencing cardiovascular outcomes, and that some patient subgroups, such as women, patients with an early-onset myocardial infarction, and patients with adverse psychosocial exposures, may be at especially high risk for these effects. This review summarizes recent knowledge on mind-body connections in CVD among cardiac patients and highlights important pathways of risk which could become the object of future intervention efforts. As a whole, this research suggests that an integrated study of mind and body is necessary to fully understand the determinants and consequences of CVD.

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Section: Overview Of Contributions Of Laboratory Research On Mental Stressmentioning

confidence: 89%

Section: Overview Of Contributions Of Laboratory Research On Mental Stressmentioning

confidence: 99%

Section: Overview Of Contributions Of Laboratory Research On Mental Stressmentioning

confidence: 99%

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Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient

et al. 2021

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“…Previous study indicated that women responded to acute stressors in a more pro-inflammatory fashion with increased mobilization of various immune cells than men [3] . Recent study indicated that higher IL-6 and MCP-1 stress response was associated with cardiovascular events among women only [21] . Those results indicated female were more sensitive to psychological stress.…”

Section: Discussionmentioning

confidence: 99%

Immune response of frontline medical workers providing medical support for Wuhan COVID-19 patients, China

Yang

Wang

Zhang

et al. 2021

International Immunopharmacology

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The outbreak of novel coronavirus disease 2019 (COVID-19) posed a great challenge and stress to frontline medical workers in China. Stress is closely related to immunity. However, the immune response of frontline medical workers providing medical support for COVID-19 patients is unclear. Here, we reported the immune response of 76 frontline medical workers and 152 controls from the Second Affiliated Hospital of Xi’an Jiaotong University. The frontline medical workers were involved in the care for Wuhan COVID-19 patients from February 8 to March 31, 2020 in Tongji Hospital of Huazhong University of Science and Technology. The controls were medical workers of our hospital who had not been in contact with COVID-19 patients during the same period. Demographic and clinical data, including routine blood test data were extracted from the electronic health examination record and retrospectively analyzed. The post-stress frontline medical workers had higher lymphocyte (LYM) count compared with controls or pre-stress. However, the post-stress frontline medical workers had lower monocyte (MONO) count, neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and neutrophil (NEUT) ratio than controls or pre-stress. Interestingly, we found the differences were more significantly in female subgroup and nurse subgroup. Together, these data indicated that changes of immune response were found in frontline medical workers providing medical support for Wuhan COVID-19 patients, especially in females and nurses. Those maybe caused by psychological stress and we recommend to pay more attention to mental health of frontline medical workers, and provide appropriate psychological interventions for them.

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“…Since the occurrence of cardiovascular diseases (CVD) is higher in men than women [5][6][7], endothelial dysfunctions could impact fertility in a sex-specific manner and could be indicative of gender-related differences of the hormonal milieu. The risk of stroke, coronary artery and peripheral vascular diseases is very low in young women and increases with age, achieving maximal levels after the menopause [8], similar to those described in men.…”

Section: Sex Differences In Endothelial Function Phenotypementioning

confidence: 99%

The “Hitchhiker’s Guide to the Galaxy” of Endothelial Dysfunction Markers in Human Fertility

Santi

Spaggiari

Greco

et al. 2021

IJMS

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Endothelial dysfunction is an early event in the pathogenesis of atherosclerosis and represents the first step in the pathogenesis of cardiovascular diseases. The evaluation of endothelial health is fundamental in clinical practice and several direct and indirect markers have been suggested so far to identify any alterations in endothelial homeostasis. Alongside the known endothelial role on vascular health, several pieces of evidence have demonstrated that proper endothelial functioning plays a key role in human fertility and reproduction. Therefore, this state-of-the-art review updates the endothelial health markers discriminating between those available for clinical practice or for research purposes and their application in human fertility. Moreover, new molecules potentially helpful to clarify the link between endothelial and reproductive health are evaluated herein.

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Sex differences in the inflammatory response to stress and risk of adverse cardiovascular outcomes among patients with coronary heart disease

Cited by 31 publications

References 70 publications

Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient

Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient

Immune response of frontline medical workers providing medical support for Wuhan COVID-19 patients, China

The “Hitchhiker’s Guide to the Galaxy” of Endothelial Dysfunction Markers in Human Fertility

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