Happy heart syndrome: role of positive emotional stress in takotsubo syndrome.
Happy heart syndrome: role of positive emotional stress in takotsubo syndrome.
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DOI：
10.1093/eurheartj/ehv757
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发表时间：
2016-10-01
影响因子：
39.3
通讯作者：
InterTAK Co-investigators:
中科院分区：
文献类型：
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作者：
Ghadri JR;Sarcon A;Diekmann J;Bataiosu DR;Cammann VL;Jurisic S;Napp LC;Jaguszewski M;Scherff F;Brugger P;Jäncke L;Seifert B;Bax JJ;Ruschitzka F;Lüscher TF;Templin C;InterTAK Co-investigators:
Takotsubo综合征（TTS）通常由悲伤，愤怒或恐惧等负面压力引起，导致流行术语“心碎综合征”。然而，积极情绪触发TTS的作用仍不清楚。本研究的目的是分析TTS患者的患病率和特点的愉快的事件，这是不同的压力或不良事件通常触发TTS。将先前有愉快事件的Takotsubo综合征患者与国际Takotsubo登记处的负性情绪触发者进行比较。在1750例TTS患者中，我们确定了485例明确的情绪触发。其中，4.1%（n = 20）的人提出了愉快的前事件和95.9%（n = 465）的明确的负面情绪事件与TTS。有趣的是，“开心综合征”患者的临床表现与“心碎综合征”患者相似，包括胸痛等症状[89.5%（17/19）vs. 90.2%（412/457），P = 1.0]。同样，心电图参数、实验室检查结果和1年结局也无差异。然而，在一项事后分析中，与“心碎”相比，“快乐的心”中心室受累的患病率不成比例地更高（35.0 vs. 16.3%，P = 0.030）。我们的数据表明，TTS可以触发不仅是消极的，但也积极的生活事件。虽然两组患者的特征相似，但心室中部TTS类型在“快乐的心”中比在“破碎的心”中更普遍。据推测，尽管快乐和悲伤的生活事件具有不同的性质，但它们可能具有相似的最终共同情感路径，这最终会引发TTS。
Takotsubo syndrome (TTS) is typically provoked by negative stressors such as grief, anger, or fear leading to the popular term ‘broken heart syndrome’. However, the role of positive emotions triggering TTS remains unclear. The aim of the present study was to analyse the prevalence and characteristics of patients with TTS following pleasant events, which are distinct from the stressful or undesirable episodes commonly triggering TTS. Takotsubo syndrome patients with preceding pleasant events were compared to those with negative emotional triggers from the International Takotsubo Registry. Of 1750 TTS patients, we identified a total of 485 with a definite emotional trigger. Of these, 4.1% (n = 20) presented with pleasant preceding events and 95.9% (n = 465) with unequivocal negative emotional events associated with TTS. Interestingly, clinical presentation of patients with ‘happy heart syndrome’ was similar to those with the ‘broken heart syndrome’ including symptoms such as chest pain [89.5% (17/19) vs. 90.2% (412/457), P = 1.0]. Similarly, electrocardiographic parameters, laboratory findings, and 1-year outcome did not differ. However, in a post hoc analysis, a disproportionate higher prevalence of midventricular involvement was noted in ‘happy hearts’ compared with ‘broken hearts’ (35.0 vs. 16.3%, P = 0.030). Our data illustrate that TTS can be triggered by not only negative but also positive life events. While patient characteristics were similar between groups, the midventricular TTS type was more prevalent among the ‘happy hearts’ than among the ‘broken hearts’. Presumably, despite their distinct nature, happy and sad life events may share similar final common emotional pathways, which can ultimately trigger TTS.