Michael Miller, Music to My Ears
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Cleveland Heartlab 5th Annual Symposium: Michael Miller, Music to My Ears: The Benefit of Positive Emotions for Your Heart
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Michael Miller, Music to My Ears
- 1. Music to My Ears: The Benefit of Positive Emotions for Your Heart Michael Miller, MD, FACC, FAHA Professor of Medicine, Epidemiology & Preventive Medicine University of Maryland School of Medicine
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- 4. Sudden Cardiac Death Occurs: • The first manifestation in ~ 30% of individuals Background Myerburg RJ and Junttila MJ. Circulation. 2012; 125: 1043-1052.
- 5. THE LANCET PSYCHOLOGICAL STRESS AND FATAL HEART ATTACK: THE ATHENS (1981) EARTHQUAKE NATURAL EXPERIMENT Dimitrios Trichopoulos, XenophonZavitsanos, Klea Katsouyanni, Anastasia Tzonou and Panagiota Dalla-Vorgia Department of Hygiene and Epidemiology, University of Athens Medical School, Goudi,, Athens 609, Greece Volume 321, Issue 8322, 26 February 1983, Pages 441-444
- 6. Effects of Mental Stress on Regional Myocardial Uptake J Am Coll Cardiol. 2009;53:936-46
- 7. Endothelial Dysfunction Leads to Imbalance of Factors, Resulting in Vascular Disease Normal Endothelium Abnormal Endothelium LDL-C HTN Diabetes Smoking Lipid Deposition ¯ Clearance Dysfunction Adapted from Vogel RA. Am J Med 1999;107:479-487. Vascular Tone Retard Platelet & Leukocyte Adhesion Barrier to LDL-C Degrade VLDL-C & Chylotriglyceride (lipase) Inhibit SMC Migration/ Proliferation Vasoconstriction Platelet/ Leukocyte Adhesion SMC Migration & Proliferation AII IGF1 Nitric oxide
- 8. Artery before and after exposure to stress
- 9. Hardening of the Artery: The Effects of Chronic Stress Endothelial Cells Subendothelial Space Internal Elastic Lamina LDL Blood Monocytes Foam Angry Cells Macrophages Oxidized LDL MCP-1 O2 OH O2 OH Smooth Muscle Cell
- 11. Positive Emotions: Neuropeptide & Vascular Crosstalk Scientific American 304, 92 (2011)
- 12. Heal Your Heart: The Positive Emotions Prescription Coordinated Effort focusing on Nutrition Physical Activity Stress Management
- 13. Heal Your Heart: The Positive Emotions Prescription Coordinated Effort focusing on Nutrition Physical Activity Stress Management
- 14. Heal your Heart Nutrition: The Top 50 Foods Delicious Heart Healthy Mood Elevating
- 15. Artichokes Heart Healthy: Artichokes are #7 of USDA top 20 antioxidant-containing foods. Reduces LDL oxidative modification. Maintain health of the endothelium. Improves blood flow, reduces plaques & prevents blood clots from forming. X. Wu et al., J Agric Food Chem 2004;52:4026–4037.
- 16. Artichokes Mood Elevation: Excellent source of magnesium (50 mg/medium artichoke) Mg enhances arterial expansion & reduces susceptibility to dysrhythmia Magnesium boosts memory and mood. USDA Agricultural Research Service, “National Nutrient Database for Standard Reference,” release 26, http://ndb.nal.usda.gov/ndb/search/list.
- 17. Beets Heart Healthy: color from betanin, powerful antioxidant that protects the lining of arteries from free radicals and lowers homocysteine. Mood: increases serotonin and dopamine production. High concentration of uridine increases blood flow to the brain, improves and cognition. Schwahn et al., “Betaine Supplementation Improves the Atherogenic Risk Factor Profile in a Transgenic Mouse Model of Hyperhomocysteinemia,” Atherosclerosis 2007;195:100–107.
- 18. Celery Heart Healthy: 3-4 Celery Ribs or 1-2 glasses celery juice lowers SBP ~5-10 mmHg (3-n-butylphthalide- NBP). Flavonoid Luteolin- anti-inflammatory properties/may reduce infarct size. Mood: contains 1. Androsterone (pheromone), increases mood and arousal. 2. Phthalide reduces stress hormone levels/calming effect. Moghadam et al. Journal of Medicinal Food 2013;16:558–63. Sun et al., PLoS ONE 2012;7(3):e33491 Jang et al. J Nutr 2010;14:1892–98.
- 19. Cherries Heart Healthy: Great source of flavonoids, fiber, iron, magnesium, potassium, and vitamins A, B6, C and E. Mood: Tart or sour (Montmorency) cherries are high in the sleep regulating hormone melatonin. Drinking a tart cherry juice concentrate each night for a week improved overall sleep quality. McCune et al., “Cherries and Health: A Review,” Critical Reviews in Food Science and Nutrition 51, no. 1 (2011): 1–12.
- 20. Chili Peppers Heart Healthy: Transforms inactive white fat regions (beige fat) to energy-burning brown fat. Capsinoid caps (6 mg/d x 6 wks) reduced waist size by 1.2 inches. Capsaicin also inhibits Cox-2, improves endothelial function and modestly lowers LDL cholesterol. Mood: Prominent Endorphin releaser. S. Snitker et al., AJCN 2009;89:45–50.
- 21. Heal Your Heart: The Positive Emotions Prescription Coordinated Effort focusing on Nutrition Physical Activity Stress Management
- 22. New lifestyle guidelines: More exercise 2000 Report 2005 Report ≥ 30 minutes of moderate physical activity 5-7 days/week ≥ 30 minutes of moderately intense exercise every day 60 min to prevent weight gain -Brisk Walking -Dancing -Swimming HHS/USDA. www.healthierus.gov/dietaryguidelines. Exercise
- 23. NEAT (Non Exercise Activity Thermogenesis) NEAT lifestyles burn ~350 cals/d. Walk up one or two flights of stairs Chop, slice, and dice your veggies Fidget throughout the day. Don’t sit for more than 15 m at a time. Levine et al, ATVB 2006, 26: 729–36.
- 24. Heal your Heart The Positive Emotions Prescription Physical Activity Tips: Always warm-up & cool-down Aerobic activities such as brisk walking 30 minutes a day (150 minutes/week) Maximize NEAT by moving every 10 to 15 minutes during the day.
- 25. Heal Your Heart: The Positive Emotions Prescription Coordinated Effort focusing on Nutrition Physical Activity Stress Management
- 26. How Would You Respond? Situational Humor Questionnaire: You arrived at a party to find someone else wearing a piece of clothing identical to yours... 1.I wouldn't have found it particularly amusing. 2.I would have been amused but wouldn't have shown it outwardly. 3.I would have smiled. 4.I would have laughed. 5.I would have laughed heartily.
- 27. You thought you recognized a friend in a crowded room. You attracted the person's attention, ran over, but when you got there you realized that the person was a total stranger... 1.I would not have been particularly amused. 2.I would have been amused, but wouldn't have shown it outwardly. 3.I would have smiled. 4.I would have laughed. 5.I would have laughed heartily.
- 28. In choosing your friends, how desirable do you feel it is for them to be easily amused and able to laugh in a wide variety of situations? 1. The most important characteristic I look for in a friend. 2. Very desirable, but not the most important characteristic. 3. Quite desirable. 4. Neither desirable nor undesirable 5. Not very desirable
- 29. Inverse Association Between Sense of Humor and CHD (n=300) CHD subjects higher Cook-Medley Hostility scores than controls CHD subjects: 40% less likely to respond favorably to situational humor Int J Cardiol:2001; 80: 87
- 30. BART: Methodology Endothelial Cells 200mmHg
- 33. The Farrelly Brothers Present…
- 34. Results 11.4 + 3.5 Baseline Laughter Baseline Anguish FMD % 8.8 + 2.8 9.6 + 4.1 7.7 + 3.5 Heart 2006;92:261
- 35. Laughing Reduces Arterial Stiffness by PWV & AI Vlachopoulos C et al. Psychosomatic Medicine. 71(4):446-453, May 2009.
- 36. Proposed Pathway Linking Laughter to Healthy Blood Vessels Miller M, Fry WF. Med Hypotheses. 2009;73:636-9.
- 37. “Invincible Musicians” BB King (88 y/o) 1987 Inductee Willie Nelson (81 y/o) Induction Pending
- 38. Music and the Heart Overall: ↑ HRV, ↓ IL-6 Raglio et al, Curr Aging Sci. 2010;3:242-246 Okada et al. Int Heart J 2009;50:95–110 Post-MI: Classical Music x 72 h (↓HR, RR, distress) J. M. White, Am J Crit Care 1999;8:220–30 HTN: Self-Selected Music 25 min/d x 4 wks: (↓ SBP 12 mmHg & DBP 5 mm Hg) Teng et al, Conf Proc IEEE Eng Med Biol Soc. 2007:4649-4651. Post-IABP: ↓ BP, RR, distress Cadigan et al, Prog Cardiovasc Nurs 2001;16: 5–13.
- 39. Music in Hospitalized Patients SICU: 1-hr Mozart (slow movements of piano sonata) ↓ BP, ↓ HR, ↓ DHEA, ↓ IL-6, ↑ GH ↓ sedatives required Post-Op: ↓ intubation hospital d/c Conrad et al. Crit Care Med. 2007; 35:2709-2713. Twiss et al. Nurs Crit Care 2006;11: 224–31.
- 40. Music and pre-existing CHD Cochrane Database of 26 trials (1369 participants) Self-Selected Music ↓ SBP, ↓ HR, ↓ RR, ↑ Sleep Quality, ↑ Pain Thresholds Bradt et al, Cochrane Database Syst Rev. 2013 Dec 28;12:CD006577
- 41. Evidence for Dopamine Release during Pleasurable music listening Salimpoor et al. Nat Neurosci. 2011;14:257-262.
- 42. Anatomically distinct dopamine release during anticipation and experience of peak emotion to music Salimpoor et al. Nat Neurosci. 2011;14:257-262.
- 43. Divergent effects of Joyful & Anxiety-Provoking Music on Endothelial Vasoreactivity Randomized 4-pphhaassee ccrroossssoovveerr && ccoouunntteerrbbaallaanncceedd iinntteerrvveennttiioonnss Laughter (SNL, Something about Mary…) Joyful music (self-selected) Anxious music (to elicit stressful response) Relaxation (guided with visual, auditory imagery) --EEaacchh iinntteerrvveennttiioonn sseeppaarraatteedd bbyy mmiinniimmuumm ooff 11 wweeeekk --JJooyyffuull MMuussiicc pprreeffeerreenncceess wwiitthhhheelldd ffoorr aatt lleeaasstt 22--wweeeekkss
- 44. Divergent effects ooff JJooyyffuull && AAnnxxiieettyy--PPrroovvookkiinngg MMuussiicc oonn EEnnddootthheelliiaall VVaassoorreeaaccttiivviittyy %% FFMMDD Baseline- Post p-value Laughter 10.7 → 12.7 0.08 Joyful Music 10.1 → 12.8 0.0002 Anxious Music 10.6 → 10.0 0.37 Relaxation 10.6 → 11.7 0.46
- 45. Hyperemic Responses 1 Minute after BBPP CCuuffff RReelleeaassee after Joyful Music and Anxious Music Joyful Music Anxious Music Brachial Artery Diameter
- 46. Advances in Oxytocin Research Music increases Oxytocin levels post-CABG Oxytocin: Primes Mesenchymal Stem Cells to Enhance cardiac repair in Ischemia/Reperfusion Injury. Oxytocin: Improves muscle regeneration through activation of the MAPK/ERK signaling pathway. Intranasal Oxytocin in Clinical Trials Nilsson U. J Clin Nurs. 2009;18:2153-2161 Kim et al, Cells Tissues Organs 2012;195:428–442 Elabd et al. Nature Communications, 2014
- 47. Music to My Ears: The Positive Emotions Prescription Summary Consume > 5 PE promoting foods daily Exercise & Practice NEAT Laugh “until you cry” Listen to music that induces the “Frisson Effect”
Editor's Notes
- approximately two thirds of all SCDs caused by CHD occur either as a first clinical manifestation of the underlying disease or in subjects in whom disease has been identified but individual risk prediction, based on current strategies for risk profiling, suggests are at low risk.
- Effect of Mental Stress and Exercise on Regional Myocardial Uptake Changes in regional myocardial uptake or rubidium-82 and in electrocardiogram in relation to chest pain before and after mental arithmetic or exercise. Control scans show homogeneous regional cation uptake. In the patient above there are defects in uptake (arrows) by the anterior wall with mental arithmetic and exercise, and these changes are accompanied by ST-segment depression and angina. A = anterior wall; FW = left ventricular free wall; S = interventricular septum. Adapted and reprinted, with permission, from Deanfield et al. (9).
- Rank Food item Serving size Total antioxidant capacity per serving size 1 Small Red Bean (dried) Half cup 13,727 2 Wild blueberry 1 cup 13,427 3 Red kidney bean (dried) Half cup 13,259 4 Pinto bean Half cup 11,864 5 Blueberry (cultivated) 1 cup 9,019 6 Cranberry 1 cup (whole) 8,983 7 Artichoke (cooked) 1 cup (hearts) 7,904 8 Blackberry 1 cup 7,701 9 Prune Half cup 7,291 10 Raspberry 1 cup 6,058
- 6 capsinoid capsules amount found in about nine chile peppers daily for up to 6 weeks activated brown
- Preferred transducer for optimal image resolution is a broad-band linear array model (7-12 MHz frequency range). Cuff is inflated (typically to 50 mm Hg above resting systolic blood pressure) for a standardized period (5 min) to create ischemia and reactive hyperemia in the downstream resistance arteries. Following cuff release, this distal hyperemia produces a transient increase in blood flow through the conduit brachial artery (~ 6x). Vasodilation is measured 1 min after cuff release.
- Miller M, Mangano C, Park Y, Goel R, Plotnick GD, Vogel RA. Heart. 2006 Feb;92(2):261-2.
- Music, an abstract stimulus, can arouse feelings of euphoria and craving, similar to tangible rewards that involve the striatal dopaminergic system. Using the neurochemical specificity of [11C]raclopride positron emission tomography scanning, combined with psychophysiological measures of autonomic nervous system activity, we found endogenous dopamine release in the striatum at peak emotional arousal during music listening. To examine the time course of dopamine release, we used functional magnetic resonance imaging with the same stimuli and listeners, and found a functional dissociation: the caudate was more involved during the anticipation and the nucleus accumbens was more involved during the experience of peak emotional responses to music. These results indicate that intense pleasure in response to music can lead to dopamine release in the striatal system. Notably, the anticipation of an abstract reward can result in dopamine release in an anatomical pathway distinct from that associated with the peak pleasure itself. Our results help to explain why music is of such high value across all human societies
- Music, an abstract stimulus, can arouse feelings of euphoria and craving, similar to tangible rewards that involve the striatal dopaminergic system. Using the neurochemical specificity of [11C]raclopride positron emission tomography scanning, combined with psychophysiological measures of autonomic nervous system activity, we found endogenous dopamine release in the striatum at peak emotional arousal during music listening. To examine the time course of dopamine release, we used functional magnetic resonance imaging with the same stimuli and listeners, and found a functional dissociation: the caudate was more involved during the anticipation and the nucleus accumbens was more involved during the experience of peak emotional responses to music. These results indicate that intense pleasure in response to music can lead to dopamine release in the striatal system. Notably, the anticipation of an abstract reward can result in dopamine release in an anatomical pathway distinct from that associated with the peak pleasure itself. Our results help to explain why music is of such high value across all human societies
- The relaxation tape was a guided relaxation spoken by Andre (i.e. breathe deeply, etc.) emotional desensitization