Current EPICORE Research Projects

The overall objective of this program project grant is to generate novel data on the causal mechanisms of mental stress-induced myocardial ischemia (MSIMI), to identify vulnerable patient groups who are susceptible to MSIMI, and to determine the clinical importance of MSIMI in a diverse and contemporary patient population with stable coronary artery disease. Subprojects will assess brain imaging and vascular correlates of MSIMI to explore potential mechanisms underlying this phenomenon.

The purpose of this project is to evaluate whether young women who have recently had a myocardial infarction (MI) are more susceptible to myocardial ischemia due to psychological stress relative to men of similar age; examine the mechanisms underlying ischemia due to psychological stress in women relative to men; and assess whether ischemia due to psychological stress is implicated in the worse prognosis of women with MI compared with men.

The purpose of this project is to examine the longitudinal association between PTSD and ischemic heart disease by doing a follow up study of twins in the Vietnam Era Twin Registry 10 years after a baseline visit that involved assessments of ischemic heart disease with positron emission tomography (PET) myocardial perfusion imaging and other measures of cardiovascular risk.

Psychological stress is a potentially major risk factor for sudden cardiac death and can cause cardiac electrical instability. This study aims to address the reasons behind sudden cardiac death by evaluating the relationship of cardiac electrical instability with posttraumatic stress disorder (PTSD). We will also study the way in which PTSD-related genes, sleep disturbance, and physical inactivity may also play a role in its potential relationship with cardiac electrical risk.

The major goal of this project is to assess the role of possible mechanisms underlying the association of depression and posttraumatic stress disorder (PTSD) with cardiovascular disease using a twin design, and examining subclinical indicators of myocardial perfusion measured with positron emission tomography (PET), and biomarkers of immune and autonomic dysregulation.

The overall aims of this study are to identify epigenetic variants associated with coronary heart disease, depression, PTSD and risk factors using monozygotic twins.

This study is designed to determine whether stressors related to interpersonal mistreatment are more strongly associated with mental stress ischemia in young African-American women, compared to white women with a history of coronary artery disease. This project also examines whether elevated blood pressure responses to these stressors during the day persist into the night  via ambulatory blood pressure monitoring.

This is a pilot study (currently in preparation phase) that aims to primarily investigate coronary blood flow changes during mental stress in 24 patients with known coronary artery disease, and the effects of a biofeedback stress reduction intervention on the changes in coronary blood flow after mental stress provocation. We also plan to investigate any changes in the autonomic and peripheral vascular function of the patients.

The aim of this study is to investigate the cardiovascular risk of early life stressors in patients undergoing evaluation for coronary artery disease. We will also evaluate for pathological stress reactivity as an intermediate risk factor in those with early life stress exposure.


Our goal is to perform a comprehensive analysis of the risk factors for heart failure readmission, including psychological, social, and physiologic. We will integrate mobile health technologies to detect changes in environment and health status over time.