Stress-induced cardiomyopathy (Takotsubo) &amp;ndash; broken heart and mind?

Redfors, Björn; Shao, Yangzhen; Ömerovic, Elmir

doi:10.2147/vhrm.s40163

Cited by 32 publications

(13 citation statements)

References 41 publications

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“…Compared with mental triggers, physical stressors have been speculated to be associated with more acute catecholamine surges that cause more significant cardiac stress and may explain why physical stressors are more often noted among youth with TTC. 113 Chronic mental stress has also been associated with increased odds of developing TTC among young patients; TTC has been shown to cause structural changes in the cerebrum, alterations of the hypothalamic–pituitary–adrenal axis, and chronic and repetitive catecholamine release. 113 , 114 The factor that predisposes patients suffering from chronic mental stress to TTC is believed to be a large emotional burden, such as that incurred via the death of a loved one, sudden bankruptcy, or unexpected unemployment.…”

Section: Discussionmentioning

confidence: 99%

“… 113 Chronic mental stress has also been associated with increased odds of developing TTC among young patients; TTC has been shown to cause structural changes in the cerebrum, alterations of the hypothalamic–pituitary–adrenal axis, and chronic and repetitive catecholamine release. 113 , 114 The factor that predisposes patients suffering from chronic mental stress to TTC is believed to be a large emotional burden, such as that incurred via the death of a loved one, sudden bankruptcy, or unexpected unemployment. Either physical or mental stress, as well as either endogenous or exogenous catecholamine surges, may precipitate an exacerbation of TTC, which appears to be a response to whole-body stress that affects the cardiocirculatory syndrome and other organ systems.…”

Section: Discussionmentioning

confidence: 99%

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A New Insight Into Sudden Cardiac Death in Young People

et al. 2015

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Takotsubo cardiomyopathy (TTC) causes sudden cardiac death and has garnered increased attention worldwide in recent years. However, few studies have clearly classified the risk factors for this disease, including gender, race and morbidity, as well as the physical and mental stressors that can exacerbate the disease, particularly in young patients. To better analyze the characteristics of young TTC patients, we performed a systematic review of reported cases involving young patients.A computer-assisted search was performed using prominent electronic medical information sources to identify literature published between January 1965 and December 2013. Relevant studies containing clinical data of young TTC patients were included.Ninety-six records that included information about 104 cases were ultimately selected for our review. Several of the following results were noted: First, physical stress was more likely to exacerbate TTC than was mental stress in young patients. Second, more female than male TTC patients were noted among both young patients and the general population. Third, ethnicity appears to play no role in the disease, as no significant differences were noted among individuals of different races with respect to clinical characteristics, morbidity or stressors. Fourth, the clinical manifestations of TTC were similar to those of other cardiac diseases, including coronary heart disease. However, TTC may be detected using the combination of echocardiography and ventriculography.Clinicians should consider TTC if young patients present with symptoms similar to those of coronary heart disease so that harmful treatments such as coronary artery stent placement may be avoided. Moreover, the answers to questions regarding the clinical diagnostic criteria, etiology, pathophysiology, and the management of this syndrome in youth remain unclear; therefore, further research is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A New Insight Into Sudden Cardiac Death in Young People

et al. 2015

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“…Also, TTC patients have been found to have higher rates of psychiatric and neurological disorders compared to ACS patients (2). Common predisposing triggering factors of TTC are life events associated with emotional (e.g., panic or anxiety, surprise birthday parties) and physical (e.g., acute respiratory failure or central nervous system conditions) stress (5, 31). More recent data have shown, that emotional triggers are not as common as physical triggers in TTC patients (5).…”

Section: Takotsubo Cardiomyopathy and Psychiatric Disordersmentioning

confidence: 99%

Takotsubo Cardiomyopathy—Acute Cardiac Dysfunction Associated With Neurological and Psychiatric Disorders

Buchmann

Lehmann

Stevens³

2019

Front. Neurol.

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Takotsubo cardiomyopathy (TTC) is an acute and reversible cardiac wall motion abnormality of the left myocardium. Although many studies focused on etiology, diagnostic and treatment of TTC, precise clinical guidelines on TTC are not available. Research revealed emotional and physical triggering factors of TTC and emphasized the association of TTC with psychiatric and particularly acute neurological disorders. Similar clinical presentation of acute coronary syndrome (ACS) and TTC patients, makes an anamnestic screening for TTC risk factors necessary. In psychiatric anamnesis affective disorders and chronic anxiety disorders are presumably for TTC. Subarachnoid hemorrhages and status epilepticus are typical acute neurological associated with a higher risk for TTC. Moreover, magnetic resonance imaging (MRI) studies reveled brain alterations of the limbic system and reduced connectivity of central autonomic nervous system structures. Diagnosis of TTC is made by elevation of cardiac enzymes, electrocardiogram (ECG) and visualization of myocardial wall motion. Major differential diagnoses like acute coronary syndrome and myocarditis are hereby in synopsis with anamnesis with respect of possible emotional and physical triggering factors of TTC ruled out. In most cases the TTC typical wall motion abnormalities resolve in weeks and therapy is only necessary in hemodynamic instable patients and if rare complications, like cardiac wall ruptures occur. Recently, the two-parted International expert consensus document on Takotsubo syndrome was published, providing a detailed characterization of TTC and allows clinicians to understand this cardiac dysfunction with a multidisciplinary view.

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“…Stress includes etiological mechanisms for depression and heart injury [10], [11]. In animal models, only special stress protocols are available to induce depression-like symptoms.…”

Section: Introductionmentioning

confidence: 99%

A Neuroendocrine Mechanism of Co-Morbidity of Depression-Like Behavior and Myocardial Injury in Rats

Wang

Liu²,

Wu³

et al. 2014

PLoS ONE

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Depression is generally a recurrent psychiatric disorder. Evidence shows that depression and cardiovascular diseases are common comorbid conditions, but the specific pathological mechanisms remain unclear. The purpose of this study is to determine the effects of depression induced by chronic unpredictable mild stress (CUMS) on myocardial injury and to further elucidate the biological mechanism of depression. Rats were used as a model. The CUMS procedure lasted for a total of 8 weeks. After 4 weeks of CUMS, treated rats exhibited a reduced sucrose preference and changes in scores on an open field test, body weight and content of 5-HT in the brain as compared with the values of these variables in controls. These changes indicated depression-like changes in CUMS rats and demonstrated the feasibility of the depression model. In addition, pathological changes in the myocardium and increased cardiomyocyte apoptosis demonstrated that myocardial injury had occurred after 6 weeks of CUMS and had increased significantly by the end of 8 weeks of CUMS. Plasma serotonin (5-HT), norepinephrine (NE) and epinephrine (E), all depression-related neuroendocrine factors, were measured by HPLC-ECD techniques, and the content of plasma corticosterone (GC) was evaluated by an I125–cortisol radioactivity immunoassay in control and CUMS rats. The results indicated that 5-HT had decreased, whereas NE, E and GC had increased in CUMS rats, and these factors might be associated with depression-induced myocardial injury. The effects of 5-HT, NE and GC on the survival rate of cultured cardiomyocytes were determined using an orthogonal design. The results showed that 5-HT was a more important factor affecting cell survival than GC or NE. The results suggested that normal blood levels of 5-HT had a cytoprotective effect. The neuroendocrine disorders characterized by decreased 5-HT combined with increased GC and NE mediated the occurrence of depression-induced myocardial injury.

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Stress-induced cardiomyopathy (Takotsubo) – broken heart and mind?

Cited by 32 publications

References 41 publications

A New Insight Into Sudden Cardiac Death in Young People

A New Insight Into Sudden Cardiac Death in Young People

Takotsubo Cardiomyopathy—Acute Cardiac Dysfunction Associated With Neurological and Psychiatric Disorders

A Neuroendocrine Mechanism of Co-Morbidity of Depression-Like Behavior and Myocardial Injury in Rats

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