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Stressed brain associated to 'broken heart,' says study

By PhilSTAR L!fe Published Mar 28, 2021 12:07 pm

Heightened activity in the brain, caused by stressful events, is linked to the risk of developing a rare and sometimes fatal heart condition called Takotsubo syndrome (TTS), also known as 'broken heart" syndrome, according to new research from the European Society of Cardiology.

The research was published in the European Heart Journal. The study found that the greater the activity in nerve cells in the amygdala region of the brain, the sooner the condition known as TTS can develop.

The researchers suggest that interventions to lower this stress-related brain activity could help to reduce the risk of developing TTS; these could include drug treatments or techniques for lowering stress.

TTS, or the "broken heart" syndrome, is characterized by a sudden temporary weakening of the heart muscles that causes the left ventricle of the heart to balloon out at the bottom while the neck remains narrow, creating a shape resembling a Japanese octopus trap, from which it gets its name.

Since this relatively rare condition was first described in 1990, evidence has suggested that it is typically triggered by episodes of severe emotional distress, such as grief, anger or fear, or reactions to happy or joyful events. Patients develop chest pains and breathlessness, and it can lead to heart attacks and death.

TTS is more common in women with only 10% of cases occurring in men.

The amygdala is the part of the brain that controls emotions, motivation, learning, and memory. It is also involved in the control of the autonomic nervous system and regulating heart function.

"The study suggests that the increased stress-associated neurobiological activity in the amygdala, which is present years before TTS occurs, may play an important role in its development and may predict the timing of the syndrome. It may prime an individual for a heightened acute stress response that culminates in TTS," said Ahmed Tawakol, co-director of the Cardiovascular Imaging Research Center at Massachusetts General Hospital and Harvard Medical School, who led the study.

"We also identified a significant relationship between stress-associated brain activity and bone marrow activity in these individuals. Together, the findings provide insights into a potential mechanism that may contribute to the 'heart-brain connection’."

For the study, Tawakol and colleagues analyzed data on 104 people with an average age of 68 years, 72% of whom were women.

The patients had undergone scans at Massachusetts General Hospital (Boston, USA) between 2005 and 2019. Most of them had the scans to see if they had cancer and the scans also assessed the activity of blood cells in the bone marrow. The researchers matched 41 people who went on to develop TTS between six months and five years after the scan with 63 who did not. The interval between the scan, the onset of TTs, last follow-up or death was an average (median) of 2.5 years for the 104 patients.

Tawakol said: "Areas of the brain that have higher metabolic activity tend to be in greater use. Hence, higher activity in the stress-associated tissues of the brain suggests that the individual has a more active response to stress. Similarly, higher activity in the bone marrow reflects greater bone marrow metabolism. The PET/CT scans produce images that reflect the distribution of glucose metabolism. The brain images thereby yield a map of brain metabolic activity: the higher the values, the greater the activity in those brain regions.” (ANI)