Matthew M Burg PhD
Associate Clinical Professor of Medicine (Cardiology)
role of emotion and stress on colonary heart disease; ischemia
Stress and Emotion in Coronary Heart Disease
Our interest in the role of stress and emotion in coronary disease has taken two approaches. We have been exploring mental stress provoked ischemia, documenting the phenomenon in naturalistic and laboratory settings. This work has allowed us to identify the anger and stress related behavioral and emotional characteristics of individuals at risk for this phenomenon, as well as the three fold greater risk of acute coronary events for people who experience this phenomenon. Additional work has served to distinguish this form of ischemia from exercise provoked ischemia, both with regard to hemodynamic characteristics and behavioral characteristics. Ongoing research is focused on the role of the central nervous system through the use of PET for the identification of brain centers uniquely activated during mental stress ischemia and the relationship of behavioral and psychological factors to such activation. In addition, the relative importance of vasculature function and processes by which vascular function is dynamically altered (e.g., inflammatory processes, autonomic modulation) are being explored. We have also been documenting the effects of acute stress and emotions such as anger on pro-arrhythmic processes in patients with implantable cardioverter defibrillators (ICD). Our findings demonstrate the profound effect that such stressors have on T-wave alternans, and the behavioral factors that contribute to risk for stress induced atrial and ventricular arrhythmias.
A second focus of our work has been on the conduct of behavioral randomized clinical trials to reduce risk in populations with extant CHD. These trials have as their focus such factors as depression in post-ACS populations and stress reduction in new recipients of implantable cardioverter defibrillators.imal circumstances for its use.