Abnormal response to mental stress in patients with Takotsubo cardiomyopathy detected by gated single photon emission computed tomography

Sciagrà, Roberto; Parodi, Guido; Pace, Stefano Del; Genovese, Sabrina; Zampini, Linda; Bellandi, Benedetta; Gensini, Gian Franco; Pupi, Alberto; Antoniucci, David

doi:10.1007/s00259-009-1362-z

Cited by 13 publications

(4 citation statements)

References 31 publications

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“…Respecto a una eventual persistencia de las alteraciones segmentarias, en relación a disturbios de catecolaminas, existe evidencia de alteración apical precoz y hasta 6 meses mediante imágenes con metayodobenzilguanidina marcada 19 . En pacientes con STT sometidos a estrés mental, al menos 1 mes post inicio del cuadro, se demostró dilatación post-estrés y alteraciones de motilidad segmentaria transitoria en la mayoría de los casos con STT respecto a grupo control, sin alteraciones coronarias 20 .…”

Section: Discussionunclassified

Síndrome de Tako-Tsubo: caso clínico

et al. 2011

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Section: Discussionunclassified

Síndrome de Tako-Tsubo: caso clínico

et al. 2011

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“…Neuroimaging studies have shown that patients with TTS have structural alterations in the limbic system and reduced functional connectivity among brain regions of the cortico-limbic network, comprising the prefrontal cortex, right insula, amygdala, hypothalamus, cingulate cortex, and thalamus, all of which regulate the autonomic nervous system and the CV response to mental stress [ 137 , 138 , 139 , 140 , 141 ]. The altered functional connectivity pattern may persist for weeks following the acute cardiac event, well after the recovery of left ventricular dysfunction [ 142 ]. Reduced functional brain connectivity may precede the development of TTS by years.…”

Section: Clinical Conditions Associated With Mental Stressmentioning

confidence: 99%

The Impact of Mental Stress on Cardiovascular Health—Part II

Henein

Vancheri

Longo³

et al. 2022

JCM

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Endothelial dysfunction is one of the earliest manifestations of atherosclerosis, contributing to its development and progression. Mental stress induces endothelial dysfunction through increased activity of the sympathetic nervous system, release of corticotropin-releasing hormone from the hypothalamus, inhibition of nitric oxide (NO) synthesis by cortisol, and increased levels of pro-inflammatory cytokines. Mental-stress-induced increased output of the sympathetic nervous system and concomitant withdrawal of the parasympathetic inflammatory reflex results in systemic inflammation and activation of a neural–hematopoietic–arterial axis. This includes the brainstem and subcortical regions network, bone marrow activation, release of leukocytes into the circulation and their migration to the arterial wall and atherosclerotic plaques. Low-grade, sterile inflammation is involved in all steps of atherogenesis, from coronary plaque formation to destabilisation and rupture. Increased sympathetic tone may cause arterial smooth-muscle-cell proliferation, resulting in vascular hypertrophy, thus contributing to the development of hypertension. Emotional events also cause instability of cardiac repolarisation due to brain lateralised imbalance of cardiac autonomic nervous stimulation, which may lead to asymmetric repolarisation and arrhythmia. Acute emotional stress can also provoke severe catecholamine release, leading to direct myocyte injury due to calcium overload, known as myocytolysis, coronary microvascular vasoconstriction, and an increase in left ventricular afterload. These changes can trigger a heart failure syndrome mimicking acute myocardial infarction, characterised by transient left ventricular dysfunction and apical ballooning, known as stress (Takotsubo) cardiomyopathy. Women are more prone than men to develop mental-stress-induced myocardial ischemia (MSIMI), probably reflecting gender differences in brain activation patterns during mental stress. Although guidelines on CV prevention recognise psychosocial factors as risk modifiers to improve risk prediction and decision making, the evidence that their assessment and treatment will prevent CAD needs further evaluation.

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“…Как известно, у пациентов с депрессивными расстройствами наблюдается нарушение обратного захвата нейронами норэпинефрина из синаптической щели [14,17]. Это, в свою очередь, способствует длительной стимуляции симпатической нервной системы (СНС) и при возникновении стрессорной ситуации может приводить к сократительной дисфункции ЛЖ [18].…”

Section: роль центральной нервной системы в патогенезе заболеванияunclassified

Takotsubo cardiomyopathy. Literature review: concept, epidemiology, pathogenesis. Part I

Болдуева

Evdokimov

2022

Russ J Cardiol

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Abnormal response to mental stress in patients with Takotsubo cardiomyopathy detected by gated single photon emission computed tomography

Abstract: Mental stress may evoke regional and/or global abnormalities in most TTC patients. The abnormal response to mental stress supports the role of sympathetic stimulation in TTC. Mental stress could thus be helpful for TTC evaluation.

Cited by 13 publications

References 31 publications

Síndrome de Tako-Tsubo: caso clínico

Síndrome de Tako-Tsubo: caso clínico

The Impact of Mental Stress on Cardiovascular Health—Part II

Takotsubo cardiomyopathy. Literature review: concept, epidemiology, pathogenesis. Part I

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