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No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy

Olov Collste1, Per Tornvall1, Örjan Sundin2

  • 1Departments of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

Plos One
|April 4, 2014
PubMed

Insights

Mental stress did not significantly affect myocardial function or heart rate variability in Takotsubo stress cardiomyopathy (TSC) patients compared to controls. Salivary cortisol levels also showed no significant difference, suggesting reduced vulnerability to mental stress post-event.

Area of Science:

  • Cardiology
  • Psychophysiology
  • Endocrinology

Background:

  • Takotsubo stress cardiomyopathy (TSC) awareness is increasing due to frequent coronary angiography.
  • The exact pathophysiology of TSC remains largely unknown.
  • Investigating the impact of mental stress on TSC patients is crucial.

Purpose of the Study:

  • To investigate the effects of mental stress on myocardial function in TSC patients.
  • To assess heart rate variability (HRV) and salivary cortisol (SC) responses to mental stress in TSC patients.
  • To compare these responses between TSC patients and healthy controls.

Main Methods:

  • A case-control study involving 22 TSC patients and 22 matched controls.
  • Mental stress tests were performed more than 6 months after the acute TSC event.
  • Myocardial function (MPI), HRV, and SC were measured before, during, and after mental stress.

Main Results:

  • No significant differences in ventricular MPI or diastolic variables between TSC patients and controls.
  • Heart rate variability (HRV) did not differ between the groups.
  • A trend towards a smaller increase in salivary cortisol (SC) was observed in TSC patients post-stress.

Conclusions:

  • Mental stress did not induce significant differences in myocardial function or HRV in TSC patients compared to controls.
  • Salivary cortisol responses to mental stress were also similar between groups.
  • Myocardial vulnerability to mental stress may not persist in TSC patients after recovery.
Abstract

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