dc.contributor.author | Malan, Leoné | |
dc.contributor.author | Hamer, Mark | |
dc.contributor.author | Von Känel, Roland | |
dc.contributor.author | Steyn, Hendrik S. | |
dc.contributor.author | Malan, Nicolaas T. | |
dc.date.accessioned | 2017-09-04T09:13:03Z | |
dc.date.available | 2017-09-04T09:13:03Z | |
dc.date.issued | 2017 | |
dc.identifier.citation | Malan, L. et al. 2017. Chronic defensiveness and neuroendocrine dysfunction reflect a novel cardiac troponin T cut point: the SABPA study. Psychoneuroendocrinology, 85:20-27. [http://dx.doi.org/10.1016/j.psyneuen.2017.07.492] | en_US |
dc.identifier.issn | 0306-4530 | |
dc.identifier.issn | 1873-3360 (Online) | |
dc.identifier.uri | http://hdl.handle.net/10394/25475 | |
dc.identifier.uri | http://www.psyneuen-journal.com/article/S0306-4530(17)30352-9/fulltext | |
dc.identifier.uri | http://dx.doi.org/10.1016/j.psyneuen.2017.07.492 | |
dc.description.abstract | Background
Sympatho-adrenal responses are activated as an innate defense coping (DefS) mechanism during emotional stress. Whether these sympatho-adrenal responses drive cardiac troponin T (cTnT) increases are unknown. Therefore, associations between cTnT and sympatho-adrenal responses were assessed.
Methods
A prospective bi-ethnic cohort, excluding atrial fibrillation, myocardial infarction and stroke cases, was followed for 3 years (N = 342; 45.6 ± 9.0 years). We obtained serum high-sensitive cTnT and exposure measures [Coping-Strategy-Indicator, depression/Patient-Health-Questionnarie-9, 24 h BP, 24 h heart-rate-variability (HRV) and 24 h urinary catecholamines].
Results
Blacks showed moderate depression (45% vs. 16%) and 24 h hypertension (67% vs. 42%) prevalence compared to Whites. A receiver-operating-characteristics cTnT cut-point 4.2 ng/L predicting hypertension in Blacks was used as binary outcome measure in relation to exposure measures [AUC 0.68 (95% CI 0.60-0.76); sensitivity/specificity 63/70%; P ≤ 0.001]. Bi-ethnic cTnT-incidence was similar (Blacks=27%, Whites=25%) with cTnT-recovery better in Blacks (9%) compared to Whites (5%), P = 0.001. In cross-sectional analyses, elevated cTnT was related to DefS [OR 1.08 (95% CI 0.99–1.16); P = 0.06]; 24 h BP [OR 1.03–1.04 (95% CI 1.01–1.08); P ≤ 0.02] and depressed HRV [OR 2.19 (95% CI 1.09–4.41); P = 0.03] in Blacks, but not in Whites. At 3 year follow-up, elevated cTnT was related to attenuated urine norepinephrine:creatinine ratio in Blacks [OR 1.46 (95% CI 1.01–2.10); P = 0.04]. In Whites, a cut point of 5.6 ng/L cTnT predicting hypertension was not associated with exposure measures.
Conclusion
Central neural control systems exemplified a brain-heart stress pathway. Desensitization of sympatho-adrenal responses occurred with initial neural- (HRV) followed by neuroendocrine dysfunction (norepinephrine:creatinine) in relation to elevated cTnT. Chronic defensiveness may thus drive the desensitization or physiological depression, reflecting ischemic heart disease risk at a novel 4.2 ng/L cTnT cut-point in Blacks | en_US |
dc.language.iso | en | en_US |
dc.publisher | Elsevier | en_US |
dc.subject | Defense | en_US |
dc.subject | Depression | en_US |
dc.subject | Heart-rate-variability | en_US |
dc.subject | Catecholamine | en_US |
dc.subject | Troponin T | en_US |
dc.title | Chronic defensiveness and neuroendocrine dysfunction reflect a novel cardiac troponin T cut point: the SABPA study | en_US |
dc.type | Article | en_US |
dc.contributor.researchID | 10060871 - Malan, Leoné | |
dc.contributor.researchID | 10056173 - Malan, Nicolaas Theodor | |
dc.contributor.researchID | 22684808 - Hamer, Mark | |
dc.contributor.researchID | 10176527 - Steyn, Hendrik Stefanus | |
dc.contributor.researchID | 25499777 - Von Känel, Roland | |