High Plasma Levels of N-Terminal Pro-Atrial Natriuretic Peptide Associated With Low Anxiety in Severe Heart Failure

Herrmann‐Lingen, Christoph; Binder, Lutz; Klinge, Michael; Sander, Julia; Schenker, W; Beyermann, Beate; Lewinski, Dirk von; Pieske, Burkert

doi:10.1097/01.psy.0000073870.93003.c4

Cited by 60 publications

(40 citation statements)

References 24 publications

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“…27 Central natriuretic peptides have an antagonistic effect on blood pressure and fluid neurotransmitters in HF, and are associated with mental and emotional changes in HF. 28,29 Depression may contribute to dysregulation of the autonomic system, with reduction in the parasympathetic and increase in the sympathetic tone and its attendant increase in heart rate, reduction in heart rate variability and lower threshold for myocardial ischaemia and adverse cardiac events in patients with CVD. 30,31 The heightened sympathetic tone is associated with increased levels of cortisol, coagulant phase by increasing platelet activation 32,33 and inhibiting the synthesis of protective eicosanoids in response to the increased haemodynamic stress on the vascular wall.…”

Section: Pathophysiological Implications Of Depression In Cardiovascumentioning

confidence: 99%

Depression in Patients with Heart Failure: Is Enough Being Done?

Mbakwem¹,

Aina²,

Amadi³

2016

Cardiac Failure Review

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Depression is a major issue in heart failure (HF). Depression is present in about one in five HF patients, with about 48 % of these individuals having significant depression. There is a wide variation in reported prevalences because of differences in the cohorts studied and methodologies. There are shared pathophysiological mechanisms between HF and depression. The adverse effects of depression on the outcomes in HF include reduced quality of life, reduced healthcare use, rehospitalisation and increased mortality. Results from metaanalysis suggest a twofold increase in mortality in HF patients with compared to those without depression. Pharmacological management of depression in HF has not been shown to improve major outcomes. No demonstrable benefits over cognitive behavioural therapy and psychotherapy have been demonstrated.

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Section: Pathophysiological Implications Of Depression In Cardiovascumentioning

confidence: 99%

Depression in Patients with Heart Failure: Is Enough Being Done?

Mbakwem¹,

Aina²,

Amadi³

2016

Cardiac Failure Review

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“…So finden sich beispielsweise Zusammenhänge zwischen erhöhten Spiegeln natriuretischer Peptide und schlechter körperlicher Lebensqualität sowie vitaler Erschöpfung [21]. Natriuretische Peptide werden vom Herzen unter hämodynamischer Belastung freigesetzt und dienen daher als Indikatoren der Krankheitsschwere.…”

Section: Neuroendokrine Aktivierung Und Befindenunclassified

“…Das Ausmaß der subjektiven Einschränkung korreliert dabei hoch mit dem Schweregrad nach NYHA und auch signifikant mit der maximalen Sauerstoffaufnahme unter Belastung, jedoch kaum mit der Ejektionsfraktion [24,25] oder einer diastolischen Dysfunktion [26]. Neuroendokrine Marker wie NT-proANP [21], NTproBNP oder MR-proADM [26] …”

Section: Lebensqualitätunclassified

Psychosomatik der Herzinsuffizienz

Herrmann‐Lingen

2011

Herz

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Psychosocial factors are bi-directionally associated with the pathophysiology, symptoms, and prognosis observed in heart failure. Cardiac symptom severity is both dependent on psychological appraisal processes and causally related to feelings of exhaustion and distress. Distress and depression have been shown to affect physiological processes involved in the pathogenesis and course of chronic heart failure as well as illness behaviors. Conversely, physiological consequences of heart failure such as inflammatory activation may lead to sickness behavior and depression. However, there are some indications that the secretion of natriuretic peptides observed in response to cardiac overload may also have beneficial psychological effects (e.g., anxiolysis). Quality of life is typically reduced in heart failure but functional impairment and psychological maladjustment seem to be more important for quality of life than cardiac severity markers such as systolic or diastolic function per se. Current guidelines therefore recommend complementing optimal medical care with good communication, the creation of a trustful physician-patient relationship, patient education and partnership building, as well as specialized mental health care in cases of severe or enduring mental disorders or inappropriate illness behavior. While the evidence for antidepressant drug treatment in heart failure appears inconclusive, behavioral treatments such as exercise and psychotherapy may be more promising in treating comorbid anxiety and depression.

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“…Studien konnten zeigen, dass Vasopressin auch bis zu 280 Tage nach dem Alkoholentzug supprimiert ist, ANP dagegen erhöht ist [18]. Zudem ist ein Zusammenhang zwi− schen ANP und anderen psychiatrischen Erkrankungsbildern, insbesondere Panikstörungen, durch mehrere Studien belegt [19,20]. Ferner gibt es Hinweise, dass Vasopressin die Freiset− zung von ACTH in der Hypophyse fördert, ANP dagegen die Frei− setzung hemmt, was einen Zusammenhang mit Craving via en− dokrinen Einflüssen auf die HPA−Achse erklären könnte (l " Abb.…”

Section: Neuroendokrinologische Veränderungenunclassified

Neurobiologische Mechanismen und Pharmakologische Behandlungsansätze des Alkohol-Craving

Hillemacher¹,

Kornhuber²,

Bleich³

2007

Fortschr Neurol Psychiatr

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In the last years, numerous studies have been performed on neurobiological mechanisms in alcohol craving. Changes in the hypothalamic cortisol pathway and the leptin metabolism, which is also associated with pharmacological interventions, have been of special interest. With acamprosate and naltrexone two substances exist for pharmacotherapy, but recent results about the efficacy are controversial. The clinical profit of disulfiram has been shown, at least in a subgroup of patients. Besides, there are several promising candidate substances. Current investigations focus on a differentiated pharmacotherapy of alcohol dependence, including psychological and genetic factors.

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High Plasma Levels of N-Terminal Pro-Atrial Natriuretic Peptide Associated With Low Anxiety in Severe Heart Failure

Cited by 60 publications

References 24 publications

Depression in Patients with Heart Failure: Is Enough Being Done?

Depression in Patients with Heart Failure: Is Enough Being Done?

Psychosomatik der Herzinsuffizienz

Neurobiologische Mechanismen und Pharmakologische Behandlungsansätze des Alkohol-Craving

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