Ischemia Clinical Trial
Official title:
Neurocardiac Interactions Evaluated by Anatomic and Physiologic MRI Assessment
The purpose of project is to answer fundamental questions about the mechanisms underlying
mental stress ischemia in patients with coronary artery disease, mood disorders, or both, and
to identify potential biomarkers and psychosocial risk factors associated with this
condition.
To achieve this goal, investigators will use cutting-edge cardiovascular and functional
neuroimaging tools to study mental stress ischemia in a carefully controlled laboratory
setting in subjects recruited from four patient populations: 1) patients who recently
sustained a myocardial infarction; 2) patients undergoing non-emergent invasive coronary
angiography (with and without known coronary artery disease); 3) patients with a diagnosis of
major depressive disorder; and 4) patients with a diagnosis of bipolar 1 or bipolar 2
disorder.
Mental stress ischemia occurs when a psychosocial or mental stressor triggers an imbalance
between the supply and demand for oxygen by cardiac myocytes. Epidemiological studies
indicate that mental stress ischemia is common, occurring in 20-25% of patients with coronary
artery disease (CAD) and portends a poor prognosis. The underlying mechanisms are thought to
involve stress-induced activation of the sympathetic nervous system and associated effects on
cardiovascular function. But how neurobiological and cardiovascular factors interact to
generate mental stress ischemia is unknown. Furthermore, patients with major depressive
disorder, bipolar disorder, and other stress-related psychiatric conditions have elevated
rates of cardiovascular co-morbidities, including sudden cardiac death, yet mental stress
ischemia has not been studied extensively in these psychiatric populations. The purpose of
project is to answer fundamental questions about the mechanisms underlying mental stress
ischemia in patients with coronary artery disease, mood disorders, or both, and to identify
potential biomarkers and psychosocial risk factors associated with this condition.
To achieve this goal, investigators will use cutting-edge cardiovascular and functional
neuroimaging tools to study mental stress ischemia in a carefully controlled laboratory
setting in subjects recruited from four patient populations: 1) patients who recently
sustained a myocardial infarction; 2) patients undergoing non-emergent invasive coronary
angiography (with and without known coronary artery disease); 3) patients with a diagnosis of
major depressive disorder; and 4) patients with a diagnosis of bipolar 1 or bipolar 2
disorder.
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