Principal Investigator: J. Douglas Bremner, MD
Population: Cardiovascular Disease with and without Depression
Summary: The purpose of this study is to address brain mechanisms through which depression increases the risk of death in patients with Coronary Heart Disease. Cardiovascular disease is the most common cause of death in the United States. Depression is a common problem among patients with coronary heart disease (CHD), ranging between 16 and 23% in these patients. Several studies have shown that depression is associated with 4-5-fold increased mortality risk in patients with CHD, which is not explained by disease severity or presence of CHD risk factors. Currently, little is known about the mechanisms by which depression confers an increased risk of death in patients with CHD. Depression has been associated with changes in brain areas that modulate emotion and the capacity to cope with stress, including prefrontal cortex and hippocampus. These brain areas have outputs to the heart which may represent the mechanism for the increased sympathetic activity associated with depression, that in turn confers increased risk for death in CHD patients. Understanding the mechanism by which depression confers greater risk for sudden death in patients with CHD has important treatment implications, for example treatment of depression with medications that act on these brain areas may actually prevent sudden death from cardiac events.