{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T15:17:15Z","timestamp":1781968635589,"version":"3.54.5"},"reference-count":60,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec id=\"jah34471-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Increasing evidence suggests a psychosomatic link between neural systems and the heart. In light of the growing burden of ischemic cardiovascular disease across the globe, a better understanding of heart\u2010brain interactions and their implications for cardiovascular treatment strategies is needed. Thus, we sought to investigate the interaction between myocardial injury and metabolic alterations in central neural areas in patients with suspected or known coronary artery disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah34471-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The association between resting metabolic activity in distinct neural structures and cardiac function was analyzed in 302 patients (aged 66.8\u00b110.2\u00a0years; 70.9% men) undergoing fluor\u201018\u2010deoxyglucose positron emission tomography and\n              <jats:sup>99m<\/jats:sup>\n              Tc\u2010tetrofosmin single\u2010photon emission computed tomography myocardial perfusion imaging. There was evidence for reduction of callosal, caudate, and brainstem fluor\u201018\u2010deoxyglucose uptake in patients with impaired left ventricular ejection fraction (&lt;55% versus \u226555%:\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.047,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.022, and\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.013, respectively) and\/or in the presence of myocardial ischemia (versus normal perfusion:\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.010,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.013, and\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.016, respectively). In a sex\u2010stratified analysis, these differences were observed in men, but not in women. A first\u2010order interaction term consisting of sex and impaired left ventricular ejection fraction or myocardial ischemia was identified as predictor of metabolic activity in these neural regions (left ventricular ejection fraction:\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.015 for brainstem; myocardial ischemia:\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.004,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.018, and\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.003 for callosal, caudate, or brainstem metabolism, respectively).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah34471-sec-0003\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Myocardial dysfunction and injury are associated with reduced resting metabolic activity of central neural structures, including the corpus callosum, the caudate nucleus, and the brainstem. These associations differ in women and men, suggesting sex differences in the pathophysiological interplay of the nervous and cardiovascular systems.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.013070","type":"journal-article","created":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T14:09:51Z","timestamp":1569852591000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Metabolic Activity in Central Neural Structures of Patients With Myocardial Injury"],"prefix":"10.1161","volume":"8","author":[{"given":"Michael","family":"Fiechter","sequence":"first","affiliation":[{"name":"University Hospital Zurich","place":["Zurich, Switzerland"]},{"name":"University of Zurich","place":["Switzerland"]},{"name":"Swiss Paraplegic Center","place":["Nottwil, 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