Brain resting state functional magnetic resonance imaging in patients with takotsubo cardiomyopathy an inseparable pair of brain and heart.
BACKGROUND
Takotsubo cardiomyopathy (TTC) is often triggered by emotional or physical stress factors. Psychological variables can have an impact on the physical manifestations of heart disease. TTC may reflect stunned myocardium from a neurogenic source. Anatomical connections between different parts of the brain can be visualized by diffusion tensor imaging (DTI) and thus, expressed by diffusion coefficient - fractional anisotropy (FA). A novel tool used to evaluate brain function in the absence of task is resting state functional magnetic resonance imaging (RS-fMRI).


METHODS
The study included both psychological tests and RS-fMRI examination, and was performed uniformly, in patients with takotsubo and healthy controls. The final group of patients consisted of 13 women, each who underwent a typical pattern of TTC triggered by emotionally stressful factors. The control group included thirteen healthy, age-matched women.


RESULTS
Psychological tests revealed that the Type D personality was not more likely to appear among studied patients with takotsubo cardiomyopathy than amongst the healthy population. However, the level of anxiety seen in patients with TTC was increased. There were no differences in FA values between patients and healthy controls. RS-fMRI showed that TTC patients had increased connectivity areas in the precuneus. The healthy controls, when compared to TTC patients had increased connectivity in the ventromedial prefrontal cortex.


CONCLUSIONS
Taking into account the RS-fMRI results, psychological testing may suggest that TTC patients place a greater focus on themselves (increased tendency to experience negative affectivity, greater conscientiousness) and might have problems with emotional control. Our findings lead to the hypothesis that there is a personality profile for TTC patients' reactions to stressful triggers.
Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland; Institute of Experimental Physics, University of Gdansk, Gdansk, Poland. Electronic address: asabisz@gumed.edu.pl.
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Sabisz
Institute of Psychology, University of Gdansk, Gdansk, Poland.
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Treder
First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.
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Fijałkowska
Department of Neurology, Medical University of Gdansk, Gdansk, Poland.
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Sieminski
Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
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Fijałkowska
Institute of Psychology, University of Gdansk, Gdansk, Poland.
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Naumczyk
First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.
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Nowak
First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.
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Jaguszewski
First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.
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Cwalina
First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.
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Gruchała
Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
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Szurowska
First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.
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Fijałkowski
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009483:Neuropsychological Tests; D010551:Personality / Q000502:physiology*; D010556:Personality Tests; D012146:Rest / Q000502:physiology; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000209:etiology / Q000523:psychology
Personality traits; Resting state functional MRI; Takotsubo cardiomyopathy