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INFORMATION FOR

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 tested the effects of psychological probes - stressful tasks and emotion recall - on cardiac performance, myocardial blood flow, and cardiac arrhythmia, documenting these phenomena 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, and the three-fold greater risk of acute coronary events for people who experience these phenomena. Additional work has served to distinguish myocardial ischemia provoked in this manner from exercise provoked ischemia, with regard to hemodynamic, vascular, inflammatory, and behavioral characteristics. In addition, the relative importance of vascular function and processes by which vascular function is dynamically altered (e.g., inflammatory processes, autonomic modulation) have been explored. We have also documented 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. We are currently testing the effects of psychological stress - under both controlled conditions and in the natural environment - on pulmonary artery pressure among patients with heart failure, and whether patients who evidence a decremental effect of this stress have worse cardiac morbidity and mortality. Past 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 leverage emerging technologies for ecological assessment of daily experiences in concert with continuous assessment of physiological indices important to vascular regulation.

Additional research focus is on quality improvement in the surgical space.

Coauthors

Research Interests

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

Selected Publications