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BOSTON – A new study reveals potential mechanisms that may contribute to ‘broken heart syndrome’, or Takotsubo syndrome (TTS), a temporary heart disease that is brought on by stressful situations and emotions. The research, which was conducted by researchers at Massachusetts General Hospital (MGH), indicates that a heart-brain connection likely plays a major role.
For the study, published in the European Heart Journal [1], the team analyzed brain imaging scans of 104 patients (41 who subsequently developed TTS and 63 who did not) to determine whether increased metabolic activity associated with stress in the brain poses a risk high to develop TTS. “Areas of the brain that have higher metabolic activity tend to be used more. Therefore, higher activity in brain centers associated with stress suggests that the individual has a more active response to stress,” he explains. lead author Ahmed Tawakol, MD, director of nuclear cardiology and co-director of the MGH Cardiovascular Imaging Research Center.
Imaging tests, which were done in patients for other medical reasons, found that increased activity in the cerebral amygdala predicted the development of later TTS, as well as the timing of the syndrome. For example, individuals with the highest tonsillar activity developed TTS within a year of imaging, while those with intermediate values developed TTS several years later.
“We show that TTS occurs not only because one encounters a rare and terribly disturbing event – such as the death of a spouse or a child, as classic examples show. On the contrary, people with High stress-related brain activity appear to be set to develop TTS – and can develop the syndrome upon exposure to more common stressors, even a routine colonoscopy or a bone fracture, ”says Tawakol.
Scientists have also identified a relationship between stress-related brain activity and bone marrow activity in individuals. Since the bone marrow produces different types of blood cells involved in transporting oxygen, increasing immune responses, and blood clotting, stress-related brain activity can influence the activity of cells that affect the body. cardiovascular health.
Applying the findings to the clinic, Tawakol hopes that interventions that reduce stress-related brain activity will make it harder for TTS to develop. “Studies should test whether such approaches for decreasing stress-associated brain activity decrease the risk of TTS recurrence in patients who have had episodes of TTS before,” he says. It also highlights the need for more studies on the impact of stress reduction – or drug interventions targeting stress-related brain activity – on heart health.
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After publication, the article will be published on the European Heart Journal website here.
This work was supported by the National Institutes of Health and the American Heart Association. Support also came from Harvard Medical School Osher Center and A. Curtis Greer and Pamela Kohlberg.
[1] “Neurobiological activity associated with stress is associated with the risk and timing of subsequent Takotsubo syndrome”, by Azar Radfar et al. European Heart Journal. doi: 10.1093 / eurheartj / ehab029About Massachusetts General Hospital
Massachusetts General Hospital, founded in 1811, is Harvard Medical School’s first and largest teaching hospital. The Mass General Research Institute leads the nation’s largest hospital-based research program, with annual research operations of more than $ 1 billion, and includes more than 9,500 researchers working in more than 30 institutes, centers and departments. In August 2020, Mass General was named # 6 in the US News and World Report list of “America’s best hospitals”.
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