Characterization of Sympathetic Nerve Activity in Stress Cardiomyopathy

University of Missouri (MU)

Status: Terminated

Conditions: Cardiomyopathy

Treatments: Device: Echocardiographic evaluation; Other: Cold Pressor Test; Device: Sympathetic Nerve Activity; Drug: The Modified Oxford Technique for Baroreflex Sensitivity; Behavioral: Mental Stress Test (Color Word Test)

Study type: Interventional

Funder types: Other

Identifiers

NCT01048125

1141858

Details and patient eligibility

About

Stress (Takotsubo) cardiomyopathy (SC) is a peculiar form of acute, reversible myocardial dysfunction predominantly affecting the apical and mid left ventricular segments.

In this institution over the last two to three years the investigators have identified more than a dozen patients with stress cardiomyopathy. The investigators' overarching goal is to characterize these individuals with the hope of identifying risk factors and developing strategies to prevent the occurrence of SC in situations where the likelihood in susceptible individuals may be high.

Full description

Stress (Takotsubo) cardiomyopathy (SC) is a peculiar form of acute, reversible myocardial dysfunction predominantly affecting the apical and mid left ventricular segments. This was originally described in Japan but is increasingly recognized all over the world especially in older women. There is evidence to support that excess sympathetic activation and catecholamine surges are potential mechanisms that cause this temporary myocardial 'stunning'. The amount of catecholamines in circulation of patients with SC was 2 to 3-fold higher when compared to subjects with acute myocardial infarction related equivalent cardiac dysfunction [Wittstein, et al. NEJM, 2005].

In this institution over the last two to three years the investigators have identified more than a dozen patients with stress cardiomyopathy. This diagnosis has been confirmed by echocardiographic documentation of normalization of left ventricular function over a course of few days to weeks. The investigators' overarching goal is to further characterize these individuals with the hope of identifying risk factors and developing strategies to prevent the occurrence of SC in situations where the likelihood in susceptible individuals may be high.

Enrollment: 2 patients

Sex: All

Ages: 21 to 90 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Diagnosis of stress cardiomyopathy in the past

Exclusion criteria

• Coronary artery disease (CAD), primary coronary intervention (PCI) or coronary artery bypass graft (CABG)
• Cardiac dysfunction
• Heart failure
• Significant arrhythmias
• Severe chronic obstructive pulmonary disease (COPD)
• Diabetic neuropathy
• Pregnancy

Trial design

Primary purpose: Basic Science

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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2 participants in 2 patient groups

Study group

Experimental group

Description:

Subjects with documented stress cardiomyopathy who would serve as the study group. Sympathetic Nerve Activity; Mental StrCold Pressor Testess Test (Color Word Test); The Modified Oxford Technique for Baroreflex Sensitivity; Cold Pressor Test; Echocardiographic evaluation

Treatment:

Other: Cold Pressor Test

Device: Echocardiographic evaluation

Drug: The Modified Oxford Technique for Baroreflex Sensitivity

Behavioral: Mental Stress Test (Color Word Test)

Device: Sympathetic Nerve Activity

Control

Active Comparator group

Description:

Control subjects will be age and sex matched otherwise healthy people with no prior cardiac disease or other severe medical conditions. Sympathetic Nerve Activity; Mental Stress Test (Color Word Test); The Modified Oxford Technique for Baroreflex Sensitivity; Cold Pressor Test; Echocardiographic evaluation

Treatment:

Other: Cold Pressor Test

Device: Echocardiographic evaluation

Drug: The Modified Oxford Technique for Baroreflex Sensitivity

Behavioral: Mental Stress Test (Color Word Test)

Device: Sympathetic Nerve Activity