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FDG-PET imaging reveals brain region that links stress and heart disease

by Lauren Dubinsky, Senior Reporter | January 13, 2017
Cardiology Molecular Imaging Stroke
MGH and Mount Sinai team up
New research led by Massachusetts General Hospital and Mount Sinai, PET/CT imaging revealed that activity in a stress-sensitive structure within the brain is linked to risk of cardiovascular disease. The findings were published in the journal The Lancet.

Although the connection between stress and heart disease has been known for some time because of animal studies, the mechanism behind it wasn't clear. This is the first time the region of the brain that connects stress to the risk of heart attack and stroke has been identified in animal models and humans.

The institutions conducted two studies — the first carried out by MGH. The researchers evaluated imaging and medical record data from almost 300 patients who underwent FDG (fluorodeoxyglucose) PET/CT brain exams primarily for cancer screening.
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All of the patients had no active cancer or cardiovascular disease at the time of the imaging exams. Each had information in their medical records on at least three additional clinical visits in the two to five years after the exams.

The second study was conducted at the Icahn School of Medicine at Mount Sinai and included 13 patients with a history of post-traumatic stress disorder. The researchers measured each patient's level of perceived stress and had them undergo FDG-PET scans to evaluate amygdala activity and arterial inflammation.

In MGH's study, 22 patients experienced a cardiovascular events such as a heart attack, stroke or episodes of angina in the follow-up period.

The research revealed that the prior level of amygdala activity strongly predicted the risk of a subsequent cardiovascular event. The association became even stronger when the researchers only considered major adverse cardiovascular events.

They found that amygdala activity was also associated with the timing of events and increased arterial inflammation. The patients with the highest levels of activity experienced events sooner than those with lower levels.

In the Mount Sinai study, the patients' current stress levels were strongly associated with both amygdala activity and arterial inflammation.

Dr. Ahmed Tawakol, lead author of the paper, stated that patients with a higher risk of cardiovascular disease should consider employing stress-reduction approaches if they have a high amount of psychosocial stress. But he cautioned that large trials are needed to confirm that stress reduction improves cardiovascular disease risk.

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