Brain fMRT In Takotsubo Cardiomyopathy

Study Overview
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Brief Summary
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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.

Official Title
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Pilot Study: Central Nervous System and Hormonal Changes In Takotsubo Cardiomyopathy

Conditions
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Takotsubo Cardiomyopathy

Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Maximum Age: 90 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| TTC<br>postmenopausal women with acute Takotsubo cardiomyopathy (TTC), diagnosis by coronary angiography within 24 hours of symptom onset | |
| NSTEMI / STEMI<br>postmenopausal women with acute ST elevation myocardial infarction (NSTEMI / STEMI), diagnosis by coronary angiography within 24 hours of symptom onset | |
| healthy subjects<br>healthy postmenopausal women without coronary artery disease | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in brain functional MRT (resting state, paradigma) in postmenopausal females suffering from TTC as compared to NSTEMI / STEMI postmenopausal female patients |  | Within the first 72h after diagnosis and after 4-8 weeks |