Brain fMRT In Takotsubo Cardiomyopathy (TAKINSULA)

Wolfgang Dichtl, MD PhD

Status: Completed

Conditions: Takotsubo Cardiomyopathy

Study type: Observational

Funder types: Other

Identifiers

NCT02240056

TAKINSULA

Details and patient eligibility

About

Certain cardiac and neurologic diseases influence each other via a still poorly understood "brain-heart axis". Subarachnoidal bleedings are well known to cause ECG alterations resembling those of myocardial infarction, along with a reduction of systolic myocardial function ("neurogenic stunned myocardium"). Alterations of the right insula region by a stroke or intracranial hemorrhage go along with a sympathetic activation (increased circulating catecholamine levels, tachycardia, arterial hypertension). In contrast, alterations of the left insula region often cause vagal reactions such as bradycardia, arterial hypotension. Takotsubo cardiomyopathy (TTC) is a just recently recognised subform of heart attacks, often caused by psychological or physical stress (death of a beloved one, divorce, job loss, infection, preoperative state). In more than 90% of cases, TTC affects postmenopausal women.

Functional MRT enables imaging of activated brain regions, either without ("resting state") or with specific stimuli. The investigators speculate that there is a specific involvement of the insula region during TTC.

Enrollment: 55 patients

Sex: Female

Ages: Under 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Postmenopausal females aged below 90 years
• Informed written consent
• TTC or NSTEMI / STEMI undergoing coronary angiography within 24 hours of symptom onset

Exclusion criteria

• Delayed coronary angiography (> 24 hours after symptom onset)
• Inability to perform rsfMRT within the first 72 hours after coronary angiography
• Inability to communicate in German language
• Contraindications for a MRT examination (including pacemaker, implantable cardioverter-defibrillator, mechanical heart valves, claustrophobia, severe adipositas)
• Drug addiction, under guardianship
• Inability to stick to the follow up examination

Trial design

55 participants in 3 patient groups

TTC

Description:

postmenopausal women with acute Takotsubo cardiomyopathy (TTC), diagnosis by coronary angiography within 24 hours of symptom onset

NSTEMI / STEMI

Description:

postmenopausal women with acute ST elevation myocardial infarction (NSTEMI / STEMI), diagnosis by coronary angiography within 24 hours of symptom onset

healthy subjects

Description:

healthy postmenopausal women without coronary artery disease