Skip to Main Content

Matthew Burg, PhD

Professor of Medicine (Cardiovascular Medicine)

Research Summary

The Role of Stress and Emotional Factors in Incident Cardiovascular Disease Risk, and the Use of Behavioral Interventions to Reduce Risk

Our interest in the role of stress and emotion (e.g., anger, depression), including post-traumatic stress, has taken two approaches. We have been exploring mental stress provoked myocardial ischemia and cardiac arrhythmia, 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 these phenomena, as well as the three fold greater risk of acute coronary events for people who experience these phenomena. Additional work has served to distinguish this form of ischemia from exercise provoked ischemia, both with regard to hemodynamic, vascular, inflammatory, and behavioral characteristics. Ongoing research is focused on the role of central nervous system mediation of inflammatory pathways, both chronically and dynamically. In addition, the relative importance of vascular 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) and with atrial fibrillation. Past and current behavioral clinical trials test the effects of behavioral and psychotherapy interventions on event free survival in these populations,and on populations with depression after acute coronary syndrome events.

A second focus of our work is on hypertension - in particular the risk of hypertension as a function of combat exposure and post-traumatic stress in young military veterans - and the importance of sleep in modulating dynamic arterial stiffness in the natural setting. We are leveraging emerging technologies for ecological assessment of daily experiences in concert with continuous assessment of physiological indices important to vascular regulation.

Specialized Terms: role of emotion and stress on coronary heart disease; ischemia

Coauthors

Research Interests

Anesthesiology; Anger; Coronary Disease; Emotions; Heart Diseases; Ischemia; Stress, Psychological

Selected Publications

  • Social Support and Cardiovascular DiseaseCzajkowski S, Arteaga S, Burg M. Social Support and Cardiovascular Disease 2022, 605-630. DOI: 10.1007/978-0-387-85960-6_25.
  • HypertensionShimbo D, Diaz K, Burg M, Schwartz J. Hypertension 2022, 771-785. DOI: 10.1007/978-0-387-85960-6_32.
  • Cardiac Arrhythmias and Sudden Cardiac DeathWhang W, Burg M. Cardiac Arrhythmias and Sudden Cardiac Death 2022, 1149-1169. DOI: 10.1007/978-0-387-85960-6_48.
  • Abstract 13116: The Association Between Depression and Mortality and Amputation Outcomes in Patients With Peripheral Artery Disease: A Systematic Review and Meta-AnalysisScierka L, Ahmed Z, Yousef S, ARHAM A, Grimshaw A, Harris K, Burg M, Mena-hurtado C, Smolderen K. Abstract 13116: The Association Between Depression and Mortality and Amputation Outcomes in Patients With Peripheral Artery Disease: A Systematic Review and Meta-Analysis Circulation 2021, 144: a13116-a13116. DOI: 10.1161/circ.144.suppl_1.13116.
  • Abstract 12342: Depression and Anxiety Disorders in Peripheral Artery Disease Admissions: Associations With Post-Revascularization Amputation and Resource UtilizationHarris K, Mena-hurtado C, Burg M, Smolderen K. Abstract 12342: Depression and Anxiety Disorders in Peripheral Artery Disease Admissions: Associations With Post-Revascularization Amputation and Resource Utilization Circulation 2021, 144: a12342-a12342. DOI: 10.1161/circ.144.suppl_1.12342.
  • Prevalence of Mental Health Burden Among Men and Women Hospitalized With Critical Limb Ischemia: Insights From the National Inpatient SampleHarris K, Arham A, Mena-Hurtado C, Burg M, Smolderen K. Prevalence of Mental Health Burden Among Men and Women Hospitalized With Critical Limb Ischemia: Insights From the National Inpatient Sample Journal Of Vascular Surgery 2021, 74: e163-e164. DOI: 10.1016/j.jvs.2021.06.247.
  • Abstract 48: Military Sexual Trauma Is Associated With Incident Hypertension In A 16-year Cohort Study Of 1.2 Million Young And Middle-aged Men And WomenGaffey A, Rosman L, Haskell S, Brandt C, Sico J, Bastian L, Dziura J, Burg M. Abstract 48: Military Sexual Trauma Is Associated With Incident Hypertension In A 16-year Cohort Study Of 1.2 Million Young And Middle-aged Men And Women Hypertension 2021, 78 DOI: 10.1161/hyp.78.suppl_1.48.
  • OPIOID PRESCRIPTION AND RISK FOR EARLY INCIDENCE OF ATRIAL FIBRILLATIONChui P, Gordon K, Burg M, Giaimo A, Dziura J, Brandt C, Bastian L. OPIOID PRESCRIPTION AND RISK FOR EARLY INCIDENCE OF ATRIAL FIBRILLATION Journal Of The American College Of Cardiology 2021, 77: 326. DOI: 10.1016/s0735-1097(21)01685-5.
  • 8 Anger and long-term mortality and ventricular tachyarrhythmias in patients with a first-time implantable cardioverter defibrillatorPedersen S, Andersen C, Burg M, Theuns D. 8 Anger and long-term mortality and ventricular tachyarrhythmias in patients with a first-time implantable cardioverter defibrillator Journal Of Psychosomatic Research 2020, 133: 109999. DOI: 10.1016/j.jpsychores.2020.109999.
  • Chapter 4 Intervention research on therapies that aim to treat depression and cardiovascular diseaseCavanagh C, Gaffey A, Rosman L, Burg M. Chapter 4 Intervention research on therapies that aim to treat depression and cardiovascular disease 2020, 61-84. DOI: 10.1016/b978-0-12-815015-3.00004-0.
  • 0341 Men and Women Veterans’ Military Experiences and Associated Risk of InsomniaGaffey A, Redeker N, Haskell S, Brandt C, Burg M. 0341 Men and Women Veterans’ Military Experiences and Associated Risk of Insomnia Sleep 2019, 42: a139-a140. DOI: 10.1093/sleep/zsz067.340.
  • An interprofessional pilot program training medical residents in trauma-sensitive communicationShamaskin-Garroway A, Burg M, Vasquez L, Brandt C, Haskell S. An interprofessional pilot program training medical residents in trauma-sensitive communication Journal Of Interprofessional Education & Practice 2017, 8: 14-19. DOI: 10.1016/j.xjep.2017.05.001.
  • Abstract P127: Posttraumatic Stress Disorder and Risk for Coronary Heart Disease: A Meta-analytic ReviewEdmondson D, Kronish I, Shaffer J, Falzon L, Burg M. Abstract P127: Posttraumatic Stress Disorder and Risk for Coronary Heart Disease: A Meta-analytic Review Circulation 2013, 127 DOI: 10.1161/circ.127.suppl_12.ap127.
  • CENTRALIZED, STEPPED, PATIENT PREFERENCE-BASED TREATMENT FOR PATIENTS WITH POST-ACUTE CORONARY SYNDROME DEPRESSION: CODIACS VANGUARD RANDOMIZED CONTROL TRIALDavidson K, Bigger J, Burg M, Carney R, Chaplin W, Czajkowski S, Duer-Hefele J, Frasure-Smith N, Freedland K, Haas D, Jaffe A, Ladapo J, Lespérance F, Medina V, Newman J, Osorio G, Parsons F, Schwartz J, Shaffer J, Shapiro P, Sheps D, Vaccarino V, Whang W, Ye S. CENTRALIZED, STEPPED, PATIENT PREFERENCE-BASED TREATMENT FOR PATIENTS WITH POST-ACUTE CORONARY SYNDROME DEPRESSION: CODIACS VANGUARD RANDOMIZED CONTROL TRIAL Journal Of The American College Of Cardiology 2013, 61: e158. DOI: 10.1016/s0735-1097(13)60159-x.
  • LONG-TERM OUTCOMES OF ENHANCED DEPRESSION TREATMENT IN PATIENTS WITH ACUTE CORONARY SYNDROMES: THE COPES RANDOMIZED CONTROLLED TRIALYe S, Shaffer J, Rieckmann N, Schwartz J, Kronish I, Ladapo J, Whang W, Burg M, Davidson K. LONG-TERM OUTCOMES OF ENHANCED DEPRESSION TREATMENT IN PATIENTS WITH ACUTE CORONARY SYNDROMES: THE COPES RANDOMIZED CONTROLLED TRIAL Journal Of The American College Of Cardiology 2013, 61: e200. DOI: 10.1016/s0735-1097(13)60201-6.
  • HEIGHTENED MEDICATION CONCERN AND SELF-REPORTED ADHERENCE AFTER ACUTE CORONARY SYNDROMESchulman-Marcus J, Burg M, Kronish I, Davidson K, Ye S. HEIGHTENED MEDICATION CONCERN AND SELF-REPORTED ADHERENCE AFTER ACUTE CORONARY SYNDROME Journal Of The American College Of Cardiology 2013, 61: e1497. DOI: 10.1016/s0735-1097(13)61497-7.
  • Stress Management with Cardiac PatientsLukens C, Turkoglu D, Burg M. Stress Management with Cardiac Patients 2012, 199-221. DOI: 10.1007/978-1-4419-5650-7_10.
  • Social support and coronary heart disease.Czajkowski S, Arteaga S, Burg M. Social support and coronary heart disease. 2011, 169-195. DOI: 10.1037/13086-007.
  • The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Study.Burg M, Czajkowski S. The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Study. 2011, 381-400. DOI: 10.1037/13086-019.
  • Chapter 32 Mechanistic and Methodological Considerations for the Imaging of Mental Stress IschemiaSoufer R, Burg M, Fernandez A. Chapter 32 Mechanistic and Methodological Considerations for the Imaging of Mental Stress Ischemia 2010, 491-505. DOI: 10.1016/b978-0-323-05796-7.00058-8.
  • Abstract 1036: Impact Of Emotions On Triggering Of Atrial FibrillationLampert R, Burg M, Brandt C, Dziura J, Liu H, Donovan T, Soufer R, Jamner L. Abstract 1036: Impact Of Emotions On Triggering Of Atrial Fibrillation Circulation 2008, 118 DOI: 10.1161/circ.118.suppl_18.s_640-a.
  • In ResponseLett H, Blumenthal J, Babyak M, Catellier D, Carney R, Berkman L, Burg M, Mitchell P, Jaffe A, Schneiderman N. In Response Health Psychology 2008, 27: 1-3. DOI: 10.1037/0278-6133.27.1.1b.
  • Cardiopatia coronarica e depressione: prevalenza, prognosi, fisiopatologia e trattamentoMaier K, Chatkoff D, Burg M. Cardiopatia coronarica e depressione: prevalenza, prognosi, fisiopatologia e trattamento 2007, 93-107. DOI: 10.1007/978-88-470-0524-2_6.
  • Stress psicologico e ischemiaBurg M. Stress psicologico e ischemia 2007, 77-90. DOI: 10.1007/978-88-470-0524-2_5.
  • Mental Stress Ischemia: Characteristics, Pathophysiology, Prognosis and TreatmentBurg M. Mental Stress Ischemia: Characteristics, Pathophysiology, Prognosis and Treatment 2006, 71-82. DOI: 10.1007/978-88-470-0378-1_5.
  • The Implications of Mental Stress for Cardiovascular DiseaseGraeber B, Soufer A, Burg M, Soufer R. The Implications of Mental Stress for Cardiovascular Disease 2006, 197-215. DOI: 10.1007/978-1-59745-096-6_11.
  • Depression and CHD: Prevalence, Prognosis, Pathophysiology and TreatmentMaier K, Chatkoff D, Burg M. Depression and CHD: Prevalence, Prognosis, Pathophysiology and Treatment 2006, 83-98. DOI: 10.1007/978-88-470-0378-1_6.
  • Electrophysiological characteristics of anger-triggered arrhythmiasStopper M, Jain D, Burg M, Joska T, McPherson C, Batsford W, Lampert R. Electrophysiological characteristics of anger-triggered arrhythmias Heart Rhythm 2005, 2: s162-s163. DOI: 10.1016/j.hrthm.2005.02.508.
  • 1148-208 Psychological stress increases heterogeneity of repolarization in patients with structural heart disease and ventricular arrhythmiasLampert R, Shusterman V, Burg M, Lee F, Earley C, Goldberg A, McPherson C, Batsford W, Soufer R. 1148-208 Psychological stress increases heterogeneity of repolarization in patients with structural heart disease and ventricular arrhythmias Journal Of The American College Of Cardiology 2004, 43: a140-a141. DOI: 10.1016/s0735-1097(04)90595-5.
  • Psychological Work With Groups in the Veterans AdministrationGreene L, Meisler A, Pilkey D, Alexander G, Cardella L, Sirois B, Burg M. Psychological Work With Groups in the Veterans Administration 2004, 322-337. DOI: 10.4135/9781452229683.n23.
  • Differences in smoking patterns in smokers with and without diabetesWagner J, Burg M, Sirois B. Differences in smoking patterns in smokers with and without diabetes Journal Of Psychosomatic Research 2003, 55: 153. DOI: 10.1016/s0022-3999(03)00177-6.
  • 7.44 Simultaneous assessment of myocardial perfusion and function during mental stress in patients with chronic coronary artery diseaseARRIGHI J, BURG M, COHEN I, SOUFER R. 7.44 Simultaneous assessment of myocardial perfusion and function during mental stress in patients with chronic coronary artery disease Journal Of Nuclear Cardiology 2001, 8: s51-s51. DOI: 10.1016/s1071-3581(01)80621-8.
  • Health Risk Behaviors and Their Relationships to Health Care Utilization Among Veterans Receiving Primary Medical CareBenedetto M, Kerns R, Rosenberg R, Burg M, Westgate K. Health Risk Behaviors and Their Relationships to Health Care Utilization Among Veterans Receiving Primary Medical Care Journal Of Clinical Psychology In Medical Settings 1998, 5: 441-447. DOI: 10.1023/a:1026258911757.
  • Day to day reproducibility of mental stress induced left ventricular dysfunctionJain D, Burg M, Soufer R, Cozza T, Zaret B. Day to day reproducibility of mental stress induced left ventricular dysfunction Journal Of The American College Of Cardiology 1996, 27: 240. DOI: 10.1016/s0735-1097(96)81835-3.
  • Ejection fraction fall during mental stress in coronary artery disease: Is it due to peripheral effects or contractile dysfunction?SHAKER S, JAIN D, BURG M, WACKERS F, SOUFER R, ZARET B. Ejection fraction fall during mental stress in coronary artery disease: Is it due to peripheral effects or contractile dysfunction? Journal Of Nuclear Cardiology 1995, 2: s27-s27. DOI: 10.1016/s1071-3581(05)80195-3.
  • Prognostic value of mental stress induced silent left ventricular dysfunction in coronary artery diseaseJAIN D, BURG M, SOUFER R, ZARET B. Prognostic value of mental stress induced silent left ventricular dysfunction in coronary artery disease Journal Of Nuclear Cardiology 1995, 2: s91-s91. DOI: 10.1016/s1071-3581(05)80449-0.
  • Mental stress induced left ventricular dysfunction: Role of changes in arterial and ventricular elastance and ventriculo-arterial couplingJAIN D, SHAKER S, BURG M, WACKERS F, ZARET B. Mental stress induced left ventricular dysfunction: Role of changes in arterial and ventricular elastance and ventriculo-arterial coupling Journal Of Nuclear Cardiology 1995, 2: s124-s124. DOI: 10.1016/s1071-3581(05)80577-x.
  • Silent left ventricular dysfunction during routine structured interview and induced mental stress in stable coronary patients: Impact of type a behaviorJain D, Burg M, Soufer R, Kerns R, Zaret B. Silent left ventricular dysfunction during routine structured interview and induced mental stress in stable coronary patients: Impact of type a behavior Journal Of The American College Of Cardiology 1991, 17: a90. DOI: 10.1016/0735-1097(91)91326-a.
  • Behavioral Approaches to Primary and Secondary Prevention of Coronary Heart DiseaseBlumenthal J, Burg M, Roark S. Behavioral Approaches to Primary and Secondary Prevention of Coronary Heart Disease 1986, 287-306. DOI: 10.1007/978-1-4684-5044-6_13.