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July 29, 2002


Emory Scientist Awarded American Heart Association Grant To Study Depression/Heart Disease Link

Viola Vaccarino, M.D., Ph.D., of the Emory Department of Medicine's Division of Cardiology, has received the American Heart Association's Established Investigator Award. The $300,000 grant will support new Emory Heart Center research into the mechanism by which depression may cause or contribute to the development of cardiovascular disease (CVD).

Dr. Vaccarino points out that researchers have long noted an apparent association between depression and cardiovascular disease - but exactly what that link represents remains a medical mystery. For example, depression may be an actual cause of heart disease or people who have cardiovascular disease could simply be more depressed than their healthier counterparts. Some scientists have also argued that depression may be a marker of worse underlying disease.

"In addition, depression and cardiovascular disease may be linked, not because there's a direct cause and effect, but because genetic or behavioral factors can influence both conditions," says Dr. Vaccarino, who is an associate professor of medicine at Emory's School of Medicine and an associate professor of epidemiology at Emory's Rollins School of Public Health. "These factors are difficult to account for in traditional study designs."

Dr. Vaccarino's research team will be able to overcome many of the limitations of past studies by using pairs of identical twins in which one sibling has major depression and the other does not. " The advantage of our study is that, because twins share their genetic makeup (which is identical if they are identical twins) and rearing environment while growing up, they are matched on numerous known and unknown factors," explains Dr. Vaccarino.

The Emory research will concentrate on the role oxidation may play in the development of CVD. During normal metabolism, cells produce small amounts of metabolites of oxygen, called reactive oxygen species, which are potentially toxic and can induce injury of body cells, including those in the artery walls. Oxidative stress is a condition in which the production of these reactive oxygen species exceeds the ability of cells to remove them, and is thought to represent the earliest stage of CVD.

"Animal and human experimental studies have found increases in a variety of oxidative markers due to exposure to psychological stress and depression. Our study will be the first to directly examine whether oxidative stress may represent a mechanism through which depression leads to cardiovascular disease, " says Dr. Vaccarino. " We will also examine genetic and environmental influences on oxidative stress levels."

The Emory scientists will examine markers of oxidative stress, inflammation, and subclinical CVD in a sample of 320 twins drawn from a large national twin registry. They will also use a variety of technologies, including Positron Emission Tomography (PET) myocardial perfusion imaging, to look for subclinical signs of CVD .

"I am honored to receive the American Heart Association's Established Investigator Award and very pleased it will enable us to investigate these important study questions about oxidative stress, CVD risk and depression," says Dr. Vaccarino. "Our study will be the first to examine the role of a novel pathway, oxidative stress, as a potential explanation for the increased cardiovascular risk in depression. The expertise of our multidisciplinary team and the state-of-the-art core laboratories and diagnostic facilities at Emory University offer a unique structural foundation and research environment for achieving our objectives."

The study will begin July 1, 2002 and continue through June 30 of 2006.

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