“Broken heart syndrome” involves more than the heart itself. PET / CT has now shown that changes in the brain as a result of stress contribute significantly to Takotsubo syndrome (TTS), a once fatal heart condition.
With these scans, providers see the uptick of stress-related activity in the amygdala area of the brain that could increase patient risk, said a team of researchers from Massachusetts General Hospital (MGH). Finding out more about this link can help improve care for people at risk.
Extreme emotional distress, such as sadness, anger, or fear, as well as happiness, can cause a sudden weakening of the heart muscle that causes swelling at the base of the left ventricle while the neck remains narrow. . All of these emotions come from the amygdala, a region of the brain that also controls the heart and nervous system.
“We will show that TTS occurs not just because one is experiencing a very traumatic event – such as the death of a spouse or child, as in the classic examples,” said team chief executive Ahmed Tawakol, MD, director of nuclear cartography. and co-director of the Cardiovascular Imaging Research Center at MGH. “Instead, individuals with high stress brain activity appear to be linked to the development of TTS – and may develop the syndrome when it comes to more common weights, even routine colonoscopy or bone fractures. ”
TTS can cause heart attacks and death, and is more common in women with only 10 percent of cases occurring in men. But, how does stress lead to TTS? Based on their research, the team believes they have identified how the brain contributes. Starting stress-sensitive muscles in the brain could be the first step, they said, as it releases stress hormones that ignite the sympathetic nervous system that triggers inflammatory cell proliferation.
“[Our] a study suggests that the increased stress-related neurobiological activity in the amygdala, which is present years before the occurrence of TTS, may play an important role in its development and may predict the timing of the amygdala. -syndrome, ”explained Takawol. “It may be a key to a higher pressure response to TTS.”
To find out if TTS patients are experiencing changes in brain activity, the Takawol team studied PET / CT scans of 104 people with an average age of 68 pictured between 2005 and 2019. Women made up 72 percent of the group. This is the first study to use PET / CT to assess brain activity before TTS is developed.
According to the assessment, 41 people continued to develop TTS between six months and five years after the scan, but 63 did not. For the group as a whole, the time between scan, TTS onset, and last scan or death was, on average, 2.5 years.
The team found that patients who developed TTS in the amygdala had a higher stress activity on their first onset, and the higher the amygdalar signal, the greater the risk of TTS. In fact, the 15 percent of patients with the highest amygdala activity developed TTS within a year from imaging, they said.
Other factors also appeared to play a role in increasing patient risk for TTS, including autoimmune disease, hyperlipidemia, smoking, and cancer.
In addition, the Takawol team identified a relationship between stress-related brain activity and bone marrow activity. This connection can be important for cardiovascular health because bone marrow secretes different types of blood cells that are involved in carrying oxygen, boosting immune responses, and shedding blood.
A connection between the brain and the heart has long been posted as an essential part of TTS development, said a team led by Hideaki Suzuki, an assistant professor at the Graduate School of Medicine of Tohoku University in Japan. As a result, this study opens the door for further study on how best to reduce brain stress-related activities.
“Higher weight-related cloud activity may represent a therapeutic target to reduce TTS, as well as other stress-related cardiovascular diseases, including chronic heart failure,” said a team. Suzuki in an accompanying edition.
Ultimately, Takawol said he hopes these decisions will feed into that goal, leading to better treatments, including drug interventions.
“Studies should test whether such approaches to reduce stress-related brain activity reduce the chance of TTS recurrence among patients with previous TTS events,” he said.
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