Abstract
The review presents recent studies demonstrating somatic shifts in psychological processes regarded as the risk factors for myocardial infarction: depression, stress, anxiety. Based upon a metaphorical term “a perfect storm”, inflammatory, immunological, neuro-humoral predisposing factors are presented, important for myocardial infarction development, as such shifts themselves, which are the somatic substrate for psychological states mediating myocardial infarction development through behavioral and biological risk factors: “sickness behavior”, “depression illness”. Both directions complete a vicious circle of psychosomatic changes. The emphasis is set on the importance of individual approach to rehabilitation and secondary prevention of myocardial infarction, as, from biopsychosocial point of view, the bottom-up and top-down psychosomatic links are unique for any patient.
Highlights
Представлен обзор исследований, демонстрирующих соматические изменения при психологических процессах, принятых как факторы риска острого инфаркта миокарда: депрессия, стресс, тревога
The review presents recent studies demonstrating somatic shifts in psychological processes regarded as the risk factors for myocardial infarction: depression, stress, anxiety
Based upon a metaphorical term “a perfect storm”, inflammatory, immunological, neuro-humoral predisposing factors are presented, important for myocardial infarction development, as such shifts themselves, which are the somatic substrate for psychological states mediating myocardial infarction development through behavioral and biological risk factors: “sickness behavior”, “depression illness”
Summary
Представлен обзор исследований, демонстрирующих соматические изменения при психологических процессах, принятых как факторы риска острого инфаркта миокарда: депрессия, стресс, тревога. Отношение рисков (ОР) для смерти от всех причин при депрессии ОР =1,8, для повторного инфаркта миокарда ОР =1,95. Риск смерти после ОКС у больных с депрессией ОР =3,41 и сохраняется высоким, несмотря на развитие технологий реваскуляризации, реабилитации, фармакотерапии. Для проверки концепции Burg MM, et al они сопоставили исходы пациентов уже перенёсших ИМ, при наблюдении в течение 2,5 лет, в зависимости от наличия признаков депрессии, а также выраженных стрессов (подысследование REGARDS-MI).
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