RecruitingACTRN12621000635864

Unravelling the Mechanisms Underpinning the Broken Heart Syndrome

Takotsubo cardiomyopathy: Truly a syndrome of cardiac catecholamine excess? Understanding the effects on cardiac sympathetic nerve activity.

Sponsor

Prof Markus Schlaich

Enrollment

80 participants

Start Date

Mar 16, 2023

Study Type

Observational

Conditions

Takotsubo Syndrome

Summary

Takotsubo syndrome, also known as the broken heart syndrome, is an acute and commonly reversible heart dysfunction characterised by changes in the structure of the heart. The condition is frequently triggered by a sudden physical or emotionally stressful event. It has long been postulated that an excess of the “fight or flight” hormones adrenaline and noradrenaline (collectively called catecholamines) caused by substantial activation of the sympathetic nervous system in the heart might play a key role in the development of this syndrome. However, this has not yet been proven, and the exact mechanism of Takotsubo syndrome remains subject to debate. The research project aims to better understand the biological mechanisms that cause this syndrome. In this study, we will, for the first time, directly measure the amount of catecholamines released from the heart in affected patients and explore its association with impaired heart function characteristic of the condition. Understanding the relevant mechanisms will allow more tailored therapies to further improve the management and outcomes of patients suffering from broken heart syndrome.

Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Plain Language Summary

Simplified for easier understanding

Takotsubo syndrome — often called "broken heart syndrome" — is a sudden, usually temporary weakening of the heart that often follows a major physical or emotional shock. The heart temporarily changes shape and struggles to pump properly, mimicking a heart attack, but without blocked arteries. It is thought to be triggered by a surge in stress hormones like adrenaline, but the exact biological mechanism has never been directly measured. This study aims to finally measure — for the first time — exactly how much adrenaline and noradrenaline are released directly from the heart itself during a Takotsubo episode, and how that relates to the heart's impaired pumping function. Understanding this could lead to more targeted treatments and better outcomes for patients. You may be eligible if you are 18 or over and have been admitted to hospital with symptoms consistent with Takotsubo syndrome, including chest pain or shortness of breath, with matching changes on ECG, blood tests, and an echocardiogram. The study enrolls patients as they are being assessed in hospital.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

Interested in this trial?

Get notified about updates and connect with the research team.

Interventions

This study aims to (1) comprehensively assess the level of cardiac sympathetic nerve activity in patients presenting with Takotsubo syndrome (TS) in the acute phase (days 1-3 after presentation) and at 3 months of follow-up; (2) to investigate whether cardiac adrenaline co-transmission plays a pathophysiologic role in TS; and (3) to evaluate the temporal changes in indices of myocardial contractility between the acute phase (days 1-3 after presentation) and at 3-month follow-up. All patients will undergo the following assessments at these time points: Pathology (cardiac enzymes, full blood count, blood glucose, kidney function & hormone profile): Baseline and 6 months. Electrocardiogram: Baseline and 6 months Transthoracic echocardiography: Baseline and 6 months Coronary angiography and ventriculography: Baseline Cardiac catheterisation: Within 1-3 days of presentation 18-FDG-PET/CT scan: Baseline and 6 months Cardiac MRI: Within 1-3 days of presentation Microneurography: Within 1-3 days of presentation and 6 months Quality of Life Questionnaires: Baseline and 6 months.