No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy.

OBJECTIVES: Due to the frequent use of coronary angiography the awareness of Takotsubo stress cardiomyopathy (TSC) has increased although the exact pathophysiology of TSC is still largely unknown. Our objective was to investigate the effects of mental stress on myocardial function, heart rate variab...

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Main Authors: Olov Collste, Per Tornvall, Örjan Sundin, Mahbubul Alam, Mats Frick
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3973547?pdf=render
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author Olov Collste
Per Tornvall
Örjan Sundin
Mahbubul Alam
Mats Frick
author_facet Olov Collste
Per Tornvall
Örjan Sundin
Mahbubul Alam
Mats Frick
author_sort Olov Collste
collection DOAJ
description OBJECTIVES: Due to the frequent use of coronary angiography the awareness of Takotsubo stress cardiomyopathy (TSC) has increased although the exact pathophysiology of TSC is still largely unknown. Our objective was to investigate the effects of mental stress on myocardial function, heart rate variability (HRV) and salivary cortisol (SC) in TSC patients. DESIGN: This study is a case-control study and a sub-study of the Stockholm Myocardial Infarction with Normal Coronaries (SMINC) study. SETTING: Mental stress test was performed more than 6 months after the acute event in TSC patients and age- and sex-matched controls. Standard echocardiography and tissue Doppler imaging (TDI) -derived time-phases of cardiac cycle were recorded to calculate myocardial performance index (MPI) to assess ventricular function before and during mental stress. Holter-ECG recording was made to estimate HRV before, during and after mental stress. SC was measured at baseline, before and 20 minutes after mental stress. SUBJECTS: Twenty-two TSC patients and 22 sex-and age-matched controls were recruited from the SMINC-study and investigated with a mental stress test. All TSC patients had a previous normal cardiovascular magnetic resonance investigation. RESULTS: There were no significant differences at rest or during mental stress for left and right ventricular MPI or other standard diastolic variables between TSC patients and controls. HRV did not differ between TSC patients and controls. There was a trend towards less increase in SC after mental stress in TSC patients compared to controls. CONCLUSION: Mental stress did not induce a significant difference in myocardial function or HRV response between TSC and controls. Moreover, no significant difference could be seen in SC response at baseline, during or after mental stress. This study indicates that myocardial vulnerability to mental stress does not persist in TSC patients.
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spelling doaj.art-4361a18466074bc1910533db12b7832f2022-12-22T03:35:36ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9369710.1371/journal.pone.0093697No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy.Olov CollstePer TornvallÖrjan SundinMahbubul AlamMats FrickOBJECTIVES: Due to the frequent use of coronary angiography the awareness of Takotsubo stress cardiomyopathy (TSC) has increased although the exact pathophysiology of TSC is still largely unknown. Our objective was to investigate the effects of mental stress on myocardial function, heart rate variability (HRV) and salivary cortisol (SC) in TSC patients. DESIGN: This study is a case-control study and a sub-study of the Stockholm Myocardial Infarction with Normal Coronaries (SMINC) study. SETTING: Mental stress test was performed more than 6 months after the acute event in TSC patients and age- and sex-matched controls. Standard echocardiography and tissue Doppler imaging (TDI) -derived time-phases of cardiac cycle were recorded to calculate myocardial performance index (MPI) to assess ventricular function before and during mental stress. Holter-ECG recording was made to estimate HRV before, during and after mental stress. SC was measured at baseline, before and 20 minutes after mental stress. SUBJECTS: Twenty-two TSC patients and 22 sex-and age-matched controls were recruited from the SMINC-study and investigated with a mental stress test. All TSC patients had a previous normal cardiovascular magnetic resonance investigation. RESULTS: There were no significant differences at rest or during mental stress for left and right ventricular MPI or other standard diastolic variables between TSC patients and controls. HRV did not differ between TSC patients and controls. There was a trend towards less increase in SC after mental stress in TSC patients compared to controls. CONCLUSION: Mental stress did not induce a significant difference in myocardial function or HRV response between TSC and controls. Moreover, no significant difference could be seen in SC response at baseline, during or after mental stress. This study indicates that myocardial vulnerability to mental stress does not persist in TSC patients.http://europepmc.org/articles/PMC3973547?pdf=render
spellingShingle Olov Collste
Per Tornvall
Örjan Sundin
Mahbubul Alam
Mats Frick
No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy.
PLoS ONE
title No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy.
title_full No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy.
title_fullStr No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy.
title_full_unstemmed No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy.
title_short No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy.
title_sort no myocardial vulnerability to mental stress in takotsubo stress cardiomyopathy
url http://europepmc.org/articles/PMC3973547?pdf=render
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AT pertornvall nomyocardialvulnerabilitytomentalstressintakotsubostresscardiomyopathy
AT orjansundin nomyocardialvulnerabilitytomentalstressintakotsubostresscardiomyopathy
AT mahbubulalam nomyocardialvulnerabilitytomentalstressintakotsubostresscardiomyopathy
AT matsfrick nomyocardialvulnerabilitytomentalstressintakotsubostresscardiomyopathy