hypothalamus–pituitary–adrenal axis), and an imbalance of pro- and anti-inflammatory factors. physical activity, smoking behaviour), dysfunction of endocrine systems (e.g. Bi-directional interrelations between major depression and CVD suggest that both diseases may share common pathophysiological pathways. ![]() ![]() Several studies, including large population-based analyses, report associations between MHD and incident CVD. Furthermore, in addition to being correlated with NYHA class, depression prevalence and severity were also inversely related to quality of life. For example, depression was reported in 20% of patients with New York Heart Association (NYHA) class I/II heart failure (HF), but in 42% of those with NYHA class III/IV HF in a study of 682 patients hospitalized with HF. Importantly, MHD prevalence rates vary with CVD type and severity. Similar to the general population, MHD (especially depression) are more prevalent in women and younger people with CVD. The former are major causes of morbidity, mortality and poor quality of life in patients with CVD and are also independently associated with future CVD development. Mental health disorders and CVD are common comorbidities. neurologischen Gesundheitsstörungen beim Takotsubo-Syndrom, der Peripartum-Kardiomyopathie und dem Vorhofflimmern zusammengefasst. Außerdem wird der aktuelle Wissensstand zu den Wechselwirkungen zwischen kardialen und psychischen bzw. In diesem Artikel wird erörtert, warum zum besseren Verständnis der Krankheitsentstehung und für die gezielte Diagnose und Behandlung solcher komplexer Erkrankungen multidisziplinäre Kooperationen wichtig sind. Klinische Manifestation und Phänotyp kardio-psycho-neurologischer Krankheiten hängen vom individuellen somatischen, psychosozialen und genetischen Risikoprofil und von der Resilienz des Einzelnen ab und sind bei Männern und Frauen in mancher Hinsicht unterschiedlich. Neben prinzipiellen systemischen Wechselwirkungen gibt es syndromale Krankheitsbilder, bei denen entweder vorbestehende neurologische oder psychiatrische Krankheiten das Risiko für die Entstehung der Herzerkrankung erhöhen oder zum Krankheitsgeschehen beitragen (wie beim Takotsubo-Syndrom) oder bei denen eine gestörte Interaktion von angeborenem Immunsystem und zentralem Nervensystem und/oder vorbestehende Herzkrankheiten zur Entstehung von sekundären psychiatrischen oder neurologischen Krankheiten führen (wie bei der Peripartum-Kardiomyopathie oder dem Vorhofflimmern). Mögliche Zusammenhänge zwischen kardiovaskulären und psychischen Gesundheitsstörungen und ihre prognostischen Implikationen bleiben bisher bei Diagnostik und Therapie kardiovaskulärer Patienten weitgehend unberücksichtigt, und systematische wissenschaftliche Untersuchungen dazu sind selten. Depression, Angststörung, Kognitionsverlust) gehören zu den häufigen Volkskrankheiten, sind jeweils mit schlechter Lebensqualität und hoher Morbidität und Mortalität assoziiert und kommen häufig gemeinsam vor. Kardiovaskuläre und psychische Erkrankungen (z. B. 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. 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. 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. ![]() ![]() 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). 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. depression, anxiety and cognitive dysfunction) are highly prevalent and are associated with significant morbidity and mortality and impaired quality of life. Cardiovascular diseases (CVD) and mental health disorders (MHD e.g.
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