{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T10:29:37Z","timestamp":1776853777178,"version":"3.51.2"},"reference-count":100,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL139614"],"award-info":[{"award-number":["R01HL139614"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,4,16]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Both trauma exposure and post-traumatic stress disorder (PTSD) are associated with increased risk of cardiovascular disease (CVD), the leading cause of death in the USA. Endothelial dysfunction, a modifiable, early marker of CVD risk, may represent a physiological mechanism underlying this association. This mechanism-focused cohort study aims to investigate the relationship between PTSD (both in terms of diagnosis and underlying symptom dimensions) and endothelial dysfunction in a diverse, community-based sample of adult men and women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Using a cohort design, 160 trauma-exposed participants without a history of CVD are designated to the PTSD group (n=80) or trauma-exposed matched control group (n=80) after a baseline diagnostic interview assessment. Participants in the PTSD group have a current (past month) diagnosis of PTSD, whereas those in the control group have a history of trauma but no current or past psychiatric diagnoses. Endothelial dysfunction is assessed via flow-mediated vasodilation of the brachial artery and circulating levels of endothelial cell-derived microparticles. Two higher order symptom dimensions of PTSD\u2014fear and dysphoria\u2014are measured objectively with a fear conditioning paradigm and attention allocation task, respectively. Autonomic imbalance, inflammation, and oxidative stress are additionally assessed and will be examined as potential pathway variables linking PTSD and its dimensions with endothelial dysfunction. Participants are invited to return for a 2-year follow-up visit to reassess PTSD and its dimensions and endothelial dysfunction in order to investigate longitudinal associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study is conducted in compliance with the Helsinki Declaration and University of California, Los Angeles Institutional Review Board. The results of this study will be disseminated via articles in peer-reviewed journals and presentations at academic conferences and to community partners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial pre-results\" xlink:href=\"NCT03778307\">NCT03778307<\/jats:ext-link>\n                      ; pre-results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-043060","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T13:33:30Z","timestamp":1620221610000},"page":"e043060","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Key dimensions of post-traumatic stress disorder and endothelial dysfunction: a protocol for a mechanism-focused cohort study"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct03778307","registry":"10.18810\/clinical-trials-gov","type":"preResults"}],"author":[{"given":"Shiloh","family":"Cleveland","sequence":"first","affiliation":[{"name":"Psychology, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Reed","sequence":"additional","affiliation":[{"name":"Psychology, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan L","family":"Thomas","sequence":"additional","affiliation":[{"name":"Psychology, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olujimi A","family":"Ajijola","sequence":"additional","affiliation":[{"name":"Neurocardiology Research Center of Excellence, Cardiac Arrhythmia Center, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramin","family":"Ebrahimi","sequence":"additional","affiliation":[{"name":"Medicine, University of California Los Angeles, Los Angeles, California, USA"},{"name":"Medicine, Cardiology Section, Veterans Affairs Greater Los Angeles Healthcare System, Los Angleles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzung","family":"Hsiai","sequence":"additional","affiliation":[{"name":"Medicine, University of California Los Angeles, Los Angeles, California, USA"},{"name":"Bioengineering, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Lazarov","sequence":"additional","affiliation":[{"name":"School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda K","family":"Montoya","sequence":"additional","affiliation":[{"name":"Psychology, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuval","family":"Neria","sequence":"additional","affiliation":[{"name":"Psychiatry, Columbia University Irving Medical Center, New York, New York, USA"},{"name":"Epidemiology, Columbia University Irving Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daichi","family":"Shimbo","sequence":"additional","affiliation":[{"name":"Medicine, Columbia University Irving Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Wolitzky-Taylor","sequence":"additional","affiliation":[{"name":"Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0217-7171","authenticated-orcid":false,"given":"Jennifer A","family":"Sumner","sequence":"additional","affiliation":[{"name":"Psychology, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,5]]},"reference":[{"key":"2025121403582276000_11.5.e043060.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000757"},{"key":"2025121403582276000_11.5.e043060.2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1995.03950240066012"},{"key":"2025121403582276000_11.5.e043060.3","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21848"},{"key":"2025121403582276000_11.5.e043060.4","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association . 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