Broken heart syndrome, also known as stress-induced cardiomyopathy or Takotsubo syndrome (TTS) is a temporary and reversible disorder that mimics the symptoms of a heart attack. It's brought on by sudden emotional or physical stress like grief or severe pain, and it's a genuine heart condition. Researchers have now learned more about the physiological mechanisms that can contribute to the problem. The findings, which were reported in the European Heart Journal, suggest that the connection between the heart and brain plays a significant role, and that some people are more likely to develop the condition.
In this work, the researchers assessed brain scans from 104 patients, 41 of whom went on to develop TTS while the other 63 did not. The scans were taken for a variety of reasons that did not involve TTS. The investigators wanted to know if metabolic activity in the brain that's associated with stress was connected to an increase in the risk of TTS.
"Areas of the brain that have higher metabolic activity tend to be in greater use. Hence, higher activity in the stress-associated centers of the brain suggests that the individual has a more active response to stress," explained senior study author Ahmed Tawakol, M.D., director of Nuclear Cardiology and co-director of the Cardiovascular Imaging Research Center at Massachusetts General Hospital.
"We show that TTS happens not only because one encounters a rare, dreadfully disturbing event such as the death of a spouse or child, as the classical examples have it. Rather, individuals with high stress-related brain activity appear to be primed to develop TTS, and can develop the syndrome upon exposure to more common stressors, even a routine colonoscopy or a bone fracture," said Tawakol.
The researchers found that in people with heightened activity in a part of the brain called the amygdala, there was an increase in the risk of a future TTS case. The amygdala activity was also linked to when TTS happened; those with the highest activity developed TTS within a year of the brain scan, and those with moderately increased activity developed TTS a few years later.
The study also suggested that brain stress and bone marrow activity are related. Cells in the bone marrow give rise to many types of cells found in the blood, which play roles in the immune response and supplying oxygen to the body, for example. Stress may therefore be impacting the production of these cells, and affecting our health in turn.
Tawakol noted that more studies should examine the effects of interventions that reduce stress, and whether a reduction in stress-related brain activity affects heart health. "Studies should test whether such approaches to decrease stress-associated brain activity decrease the chance that TTS will recur among patients with prior episodes of TTS," he added.