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REVIEW article

Front. Cardiovasc. Med.

Sec. Clinical and Translational Cardiovascular Medicine

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1632070

The Effects of 5-HT on Vascular Endothelial Dysfunction in Patients with Panic Disorder

Provisionally accepted
Wen  TianWen Tian*Yueqi  FengYueqi FengXixi  LiXixi LiZijia  LiZijia LiXinyi  HeXinyi HeYanqing  TangYanqing Tang*
  • China Medical University, Shenyang, China

The final, formatted version of the article will be published soon.

Panic Disorder (PD) is a prevalent psychiatric condition characterized by recurrent episodes of acute severe anxiety. These episodes frequently present with symptoms that overlap with those of cardiovascular diseases (CVD), such as elevated blood pressure and chest pain. Despite the prevalence and impact of this comorbidity, the underlying mechanisms are not well understood and remain underexplored. This review synthesizes current understanding and recent findings on the role of 5-hydroxytryptamine(5-HT) in the intersection of PD and vascular dysfunction. 5-HT, a critical inhibitory neurotransmitter, has been implicated in the etiology of PD and linked to panic symptoms. This review underscores the importance of 5-HT in modulating vascular tone through its action on 5-HT1B and 5-HT2A receptors, influencing the production of nitric oxide (NO) and the subsequent vasomotor response. Furthermore, the impact of 5-HT system on platelet activation and aggregation adds another layer to the complex relationship between PD and CVD. Selective serotonin reuptake inhibitors (SSRIs) have shown promise in improving vascular endothelial function. However, the influence of SSRIs on CVD outcomes remains a controversial issue with conflicting findings from various studies. The review also highlights the role of the PI3K/Akt/eNOS signaling pathway in 5-HT's influence on vascular endothelial function. In conclusion, the intricate relationship between PD, 5-HT, and vascular endothelial function warrants further investigation. A deeper understanding of these mechanisms could lead to more effective treatments for PD and related CVD, ultimately improving patients' mental health and cardiovascular outcomes.

Keywords: Panic Disorder 1, 5-HT 2, Selective Serotonin Reuptake Inhibitors 3, Vascular Endothelial Function 4, signaling pathways 5, Cardiovascular diseases 6

Received: 20 May 2025; Accepted: 05 Aug 2025.

Copyright: © 2025 Tian, Feng, Li, Li, He and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Wen Tian, China Medical University, Shenyang, China
Yanqing Tang, China Medical University, Shenyang, China

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