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New insights into the causes and treatment options for broken heart syndrome
The so-called "broken heart syndrome" ("broken heart syndrome") has been known as a clinical picture in medicine since the early 1990s. German researchers have now managed to gain new and fundamental knowledge about the causes of the disease and for a treatment option.
The clinical picture “broken heart syndrome” has been known for decades
Her or his heart was broken. Experts have known for more than 20 years that this can not only be a saying, but also a medical reality. In the early 1990s, the clinical picture "Broken-Heart-Syndrome" ("Broken-Heart-Syndrome") was first described. It had initially been found primarily in older women who had lost their husbands. It is now known in medicine that the disease can lead to long-term heart damage, among other things. German researchers have now found out more about the causes of the disease. These could contribute to better therapy.
Disease after severe mental stress
Chest pain, shortness of breath, increased cardiac enzyme values in the blood and changes in the cardiac current curve on the ECG - in acute cases, the symptoms initially indicate a heart attack.
However, about two percent of all patients with a suspected heart attack diagnosis actually suffer from a life-threatening functional disorder of the heart with similar symptoms: Takotsubo syndrome (TTS), which is also called "broken heart syndrome".
This disease occurs after a heavy mental stress, such as grief or heartache. Postmenopausal women are mostly affected.
How this syndrome arises is not yet known. The underlying mechanisms have so far been completely unclear and therapeutic approaches have been unsuccessful.
New insights into the causes of the disease
Researchers at the University Medical Center Göttingen (UMG) have now succeeded in gaining new and fundamental knowledge about the causes of the disease and for a treatment option for "broken heart syndrome".
They have identified novel signaling pathways and can also support previously assumed assumptions for a genetic predisposition. The scientists' findings are based on studies of stem cells from patients with “broken heart syndrome” from which beating heart cells were produced.
The results have now been published in the Journal of the American College of Cardiology (JACC).
Of particular importance for the development of new therapy methods
"The identification of previously unknown signal paths is of particular importance for the development of new therapy methods," said Dr. Katrin Streckfuß-Bömeke, senior author of the publication and head of the “Translational Stem Cell Research” working group at the UMG Clinic for Cardiology and Pneumology in a press release.
"With the help of stem cells and cardiac tissue from affected patients produced in the culture dish, we were able for the first time to visualize the molecular mechanisms of Takotsubo cardiomyopathy on a patient-specific level," said the expert.
The heart cells made from stem cells from "Broken-Heart-Syndrome" patients therefore show increased β-adrenergic signal transmission and sensitivity to stress hormones, so-called catecholamines, which is up to six times normal.
These two mechanisms have been identified by cardiologists as typical for those with "broken heart syndrome".
In their study, the scientists were also able to confirm the hypothesis that, due to familial clustering, there is a genetic component for “broken heart syndrome”.
A so far little-researched clinical picture
"On the basis of this work, we now want to identify genetic factors for a previous exposure in a large cohort of TTS patients and develop therapeutic long-term treatment methods," said Dr. Streiffuss-Bömeke.
In addition, the mode of action of various drugs on the diseased heart cells is to be researched further.
"The study is an important basis and a breakthrough for a previously unexplored clinical picture," said Prof. Dr. Gerd Hasenfuß, Chairman of the Heart Center of the University Medical Center Göttingen and co-author of the study.
The Japanese doctor Keigo Dote and Hikaru Sato first described the clinical picture of Takotsubo syndrome in the 1990s.
It was named after a traditional, Japanese squid trap in the form of a bulging clay jar with a narrowed neck. The reminder of the peculiar shape of the left ventricle at the end of systole was considered by the medical profession to be the result of a circulatory disorder in the heart muscle.
Since the illness often arises as a result of severe mental stress, such as the loss of a loved one, emotional stress or grief, the term “broken heart syndrome” is also used colloquially.
About two percent of all patients with a suspected heart attack diagnosis actually suffer from a "broken heart syndrome". Only a cardiac catheter examination is certain.
If it shows no occlusion of the coronary arteries, it is probably a "broken heart". Postmenopausal women are mostly affected. In the acute phase, almost a quarter of patients experience serious complications with fatalities. (ad)