Originally Posted by Tampa 928s

This was a real surprise I'm otherwise very healthy must be stress from the TB change

Originally Posted by heinrich

I have prayed for your health.

Originally Posted by Fabio421

.... If you cannot make it to the dyno day I understand. ....

Originally Posted by heinrich

How big of you

Originally Posted by Jakeman

Hi Alk,

There was a recent editorial by John Rumsfeld in Circulation. The link is http://circ.ahajournals.org/cgi/content/full/111/3/250.

"In this issue of Circulation, Mallik et al add to our understanding of the relationship between depression and outcome in cardiac patients. Prospectively evaluating 963 coronary artery bypass graft (CABG) surgery patients, they found that 25% had substantial perioperative depressive symptoms. A graded, inverse relationship was noted between the severity of perioperative depressive symptoms and improvement in physical functional status 1 year after surgery. Patients with moderate to severe depressive symptoms were one third less likely to experience improvement in physical function after the operation, even after adjustment for >20 clinical variables. In other words, perioperative depressive symptoms appear to diminish the functional benefits of CABG surgery."

"Patients with depression have high sympathetic tone, hypercortisolemia, elevated catecholamine levels, abnormal platelet activation, increased inflammatory markers, and endothelial dysfunction. Importantly, these physiological derangements are present in depressed patients who do not have cardiac disease (ie, these mechanisms are linked to depression itself), and even when not actively depressed, patients with a history of depression have at least some of these abnormalities (eg, platelet activation) as compared with patients who are not depressed."

"Another possibility is that depression is a secondary development in cardiac patients, whereby patients with more severe cardiac disease or a heavier burden of comorbid conditions may become depressed in reaction to their illnesses. In this case, adverse outcome is the result of the greater disease burden but not of depression itself. Several factors mitigate against this explanation, at least as a sole mechanism for the association between depression and cardiovascular outcomes. Multiple studies, including that by Mallik et al, have used robust risk adjustment for cardiac and noncardiac disease burden in their analyses. Accounting for these variables does not appear to eliminate the relationship, supporting the conclusion that depression is an independent predictor of outcome. Furthermore, depression precedes cardiovascular disease in multiple studies. In healthy cohorts, depression is predictive of first MI and cardiac death."

Jakeman