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Heightened activity in the brain, caused by stressful events, is linked to the risk of developing a rare and sometimes fatal heart condition, a new study suggests.
The study, published in the European Heart Journal, found the greater the activity in nerve cells in the amygdala region of the brain, the sooner the condition known as Takotsubo syndrome (TTS) can develop.
"The study suggests that the increased stress-associated neurobiological activity in the amygdala, which is present years before TTS occurs, may play an important role in its development and may predict the timing of the syndrome," said researcher Ahmed Tawakol from Massachusetts General Hospital in Boston.
TTS, also known as "broken heart" syndrome, is characterized by a sudden temporary weakening of the heart muscles that causes the left ventricle of the heart to balloon out at the bottom while the neck remains narrow, creating a shape resembling a Japanese octopus trap, from which it gets its name. Since this relatively rare condition was first described in 1990, evidence has suggested that it is typically triggered by episodes of severe emotional distress, such as grief, anger or fear, or reactions to happy or joyful events.
Patients develop chest pain and breathlessness, and it can lead to heart attacks and death. TTS is more common in women, with only 10 per cent of cases occurring in men.
The amygdala is the part of the brain that controls emotions, motivation, learning and memory. It is also involved in the control of the autonomic nervous system and regulating heart function.
For the study, the team involved 104 participants patients had undergone PET-CT scans between 2005 and 2019.
The researchers matched 41 people who went on to develop TTS between six months and five years after the scan with 63 who did not. The interval between the scan, the onset of TTs, last follow-up or death was an average (median) of 2.5 years for the 104 patients.
The researchers found that people who went on to develop TTS had higher stress-related amygdalar activity on initial scanning (measured as a ratio of amygdalar activity to activity of brain regions that counter stress) compared to individuals who did not subsequently develop TTS.