Heart-brain medicine: Update 2007
AN URGENT NEED FOR CLINICAL TRANSLATION
Clearly the underlying science of heart-brain medicine is fascinating and needs to be pursued vigorously. While the science is ongoing, the need to translate what we know to the bedside has never been greater, given the prevalence of CAD, chronic heart failure, and psychiatric and mood disorders, as well as the likelihood of an increasing incidence of PTSD in light of the Iraq war and terrorist threats.
Multiple studies have been performed to position the field for a trial to test whether treating depression leads to improved outcomes in patients with CAD. We know that patients with depression have decreased vagal tone based on decreased heart rate variability; we know that CAD can be safely treated with selective serotonin reuptake inhibitors; and we know that this patient population is more effectively treated with medications. There was a clear sentiment among faculty and attendees of the 2006 Bakken Heart-Brain Summit that the next step in the clinical science of heart disease and neurologic state is in fact a clinical trial to test the efficacy of this approach. Unfortunately, funding for such a trial from the pharmaceutical industry or government agencies is lacking. The Bakken Heart-Brain Institute is working diligently to secure private financing of such a trial from those with personal interests in moving this field forward. We hope to be able to commence such a trial in the near future. We believe the successful initiation of a multicenter trial not only will demonstrate new avenues for improving outcomes in millions of patients but will validate the concept and usher in a new age of cooperative medicine among multiple disciplines.
As we discussed last year,1 both the need for and the future of heart-brain medicine are great. The advances seen over the past year and those being pursued in basic and clinical science laboratories throughout the world are very exciting. We thank those colleagues who attended the 2007 Bakken Heart-Brain Summit, and we hope you can join us June 4–5, 2008, in Cleveland to continue this exciting pursuit.
