Major Depression and Coronary Flow Reserve Detected by Positron Emission Tomography

Abstract

Substantial evidence has linked depression to cardiac morbidity and mortality. In recent meta-analyses, major depressive disorder (MDD) was found to be associated with greater than twice the risk of new coronary heart disease (CHD) events among initially healthy subjects.^1,2 However, results are heterogeneous, and the exact mechanisms whereby MDD increases CHD risk are not clear. Many studies have found little correlation between MDD, or depressive symptoms, and measures of coronary artery disease severity such as angiographically determined coronary stenosis,^3-5 systolic dysfunction,^4-11 and exercise-induced ischemia.⁸ An unanswered question is whether MDD increases CHD risk by affecting the microvascular circulation rather than the conduit coronary arteries.