Scientists believe they have an explanation for the axiom that stress, emotional shock, or overexertion may trigger heart attacks in vulnerable people. Hormones³ released during these events appear to cause bacterial⁴ biofilms on arterial（动脉的） walls to disperse⁵（分散）, allowing plaque⁶（血小板，饰板） deposits to rupture⁷ into the bloodstream, according to research published in published in mBio®, the online open-access journal of the American Society for Microbiology. "Our hypothesis fitted with the observation that heart attack and stroke often occur following an event where elevated levels of catecholamine（儿茶酚胺） hormones are released into the blood and tissues, such as occurs during sudden emotional shock or stress, sudden exertion¹ or over-exertion" said David Davies of Binghamton University, Binghamton, New York, an author on the study.

 

Davies and his colleagues isolated⁸ and cultured different species of bacteria from diseased carotid arteries⁹ that had been removed from patients with atherosclerosis（动脉粥样硬化）. Their results showed multiple bacterial species living as biofilms in the walls of every atherosclerotic (plaque-covered) carotid artery¹⁰ tested.

 

In normal conditions, biofilms are adherent¹¹ microbial communities that are resistant¹² to antibiotic¹³ treatment and clearance¹⁴ by the immune system. However, upon receiving a molecular¹⁵ signal, biofilms undergo dispersion, releasing enzymes¹⁶ to digest the scaffolding that maintains the bacteria within the biofilm. These enzymes have the potential to digest the nearby tissues that prevent the arterial plaque deposit from rupturing¹⁷ into the bloodstream.

 

According to Davies, this could provide a scientific explanation for the long-held belief that heart attacks can be triggered by a stress, a sudden shock, or overexertion.

 

To test this theory they added norepinephrine（去甲肾上腺素）, at a level that would be found in the body following stress or exertion, to biofilms formed on the inner walls of silicone tubing.

 

"At least one species of bacteria -- Pseudomonas aeruginosa -- commonly associated with carotid arteries in our studies, was able to undergo a biofilm dispersion response when exposed to norepinephrine, a hormone² responsible for the fight-or-flight response in humans," said Davies. Because the biofilms are closely bound to arterial plaques¹⁸, the dispersal of a biofilm could cause the sudden release of the surrounding arterial plaque, triggering a heart attack.

 

To their knowledge, this is the first direct observation of biofilm bacteria within a carotid arterial plaque deposit, says Davies. This research suggests that bacteria should be considered to be part of the overall pathology（病理学） of atherosclerosis and management of bacteria within an arterial plaque lesion may be as important as managing cholesterol¹⁹（胆固醇）.

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