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Could bacteria trigger stress-induced heart attacks?
Dispersal of bacterial biofilms from atherosclerotic carotid arteries may be the trigger for heart attacks in response to stress, fear or over-exertion. This is the major finding of a new study in the American Society for Microbiology online, open access journal mBio, led by researchers from Binghamton University in New York. The dispersal may be in response to release of stress hormones such as norepinephrine and result in release of arterial plaques to which the biofilms are bound.

In this study, the research team isolated and cultured bacteria from carotid arteries that had been obtained from atherosclerotic patients. The results showed that multiple bacterial species were present in the form of biofilms on plaque-covered arteries from patients with atherosclerosis. This is the first direct observation of bacterial biofilms from carotid artery plaques. Studies on biofilms cultured on silicon tubing showed that norepinephrine at levels compatible with those observed in response to stress or exertion could induce biofilm dispersal. Dr David Davies, an author on the study, explained further: "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 hormone responsible for the fight-or-flight response in humans."

Biofilms are normally adherent and are resistant to attack from the immune system or from antibiotics. However, a molecular trigger can cause them to disperse and release enzymes which can destroy the scaffold keeping the bacteria adherent. These enzymes would also be capable of breaking down tissues that would stop arterial plaques from being released into the bloodstream. The study suggests that management of bacteria within arterial plaques should form part of the panoply of protective measures against heart attack, along with measures such as cholesterol management.


Lanter, B.B., Sauer, K. and Davies, D.G. (2014). Bacteria Present in Carotid Arterial Plaques Are Found as Biofilm Deposits Which May Contribute to Enhanced Risk of Plaque Rupture. mBio 5 (3) e01206-14; doi: 10.1128/mBio.01206-14

Press release: American Society for Microbiology; Available from [Accessed 10 June 2014]
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Could bacteria trigger stress-induced heart attacks?00