Here, it is precisely the activation of the reward system which appears to aid recovery after a heart attack. This system, a brain network, activates in positive emotional states and, in mice, this activation significantly reduces the extent of infarction scars (fibrosis) and improves post-heart attack clinical outcomes.
A causal link between the reward system and heart attack recovery
We have known for a long time that emotional states can influence heart function. Acute stress can trigger a cardiovascular event, such as a heart attack. Broken heart syndrome (or tako-tsubo), a condition in which part of the heart muscle weakens rapidly, but without blockage of the coronary arteries, can also be triggered by acute stress. Likewise, psychological processes have a well-documented impact on recovery and healing from many illnesses. Finally, negative moods, anxiety and depression can degrade and worsen heart health, while positive emotions can improve it.
A heart-brain connection: this connection, which remains less known than the gut – brain axis, could be targeted to improve treatments for heart disease. Heart attacks occur when blood flow to the heart muscle (myocardium) is obstructed by partial or complete blockage of a coronary artery by clots. In the acute phase, this can lead to various serious symptoms, including arrhythmia potentially fatal (sudden cardiac arrest). In the chronic phase, prolonged deprivation of oxygen supply to the myocardium can lead to necrosis and post-necrotic scarring as part of an inflammatory reaction. This leads to a gradual decline in the heart’s ability to pump until theheart failure.
The reward system is activated by the release of dopamine in the ventral tegmental area (VTA) of the brain. Positive expectations and motivation stimulate neurons in the VTA. Previous research has shown that activation of VTA dopamine neurons modulates immune activity, in part via regulation of the sympathetic nervous system.
The study shows that:
- stimulation of the VTA after an infarction induces a favorable modulation of the immune response within the damaged myocardium, a reduction in myocardial fibrosis, an increase in blood vessel formation and, more generally, an improvement and recovery of cardiac performance ;
- these beneficial effects on the heart are mediated, at least in part, by the secretion of the protein, component C3 of complement, by the liver, also a player in the immune system.
While there are several methods for stimulate the reward system in humans, This discovery opens new perspectives for treating heart attacks and speeding up recovery.
More broadly, it is also the demonstration of the importance of a “good mind” for recovery from a cardiac event, or many other curable illnesses.
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