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. 2022 Jul 12:9:925459.
doi: 10.3389/fcvm.2022.925459. eCollection 2022.

Pre-existing Psychiatric Morbidity Is Strongly Associated to Takotsubo Syndrome: A Case-Control Study

Gino Pozzi  1   2 , Domenico D'Amario  1   3 , Giuseppe Princi  1   3 , Giuseppe Ciliberti  1   3 , Antonella Irano  1   2 , Maria Velia Simone  1   2 , Filippo Crea  1   3 , Leonarda Galiuto  1   3
Affiliations

Pre-existing Psychiatric Morbidity Is Strongly Associated to Takotsubo Syndrome: A Case-Control Study

Gino Pozzi et al. Front Cardiovasc Med. .

Abstract

Background: Takotsubo syndrome (TTS) is an emerging disease characterized by an acute and reversible myocardial dysfunction which may have an influence on clinical status and prognosis. Despite extensive research, its pathophysiology has not been completely elucidated; among other hypothesis, a heart-brain interaction has been proposed.

Methods: The aim of this study was to assess the impact of psychiatric disorders and of some personality types on the pathogenesis of TTS. We conducted a retrospective observational case-control study. We enrolled a total of 50 patients, 25 with a previous diagnosis of TTS and 25 patients with a history of acute coronary syndrome (ACS), that underwent a comprehensive lifetime psychiatric assessment.

Results: We found no significant difference between TTS and ACS patients in cardiovascular risk profile. The frequency of lifetime psychiatric disorders was significantly greater in TTS. In particular, in the univariate analysis, TTS group showed a higher prevalence of mood disorders (Major Depressive Disorder, Bipolar Disorder, Dysthymia; 16 vs. 2, P < 0.001) and anxiety disorder (Generalized Anxiety Disorder, Panic Disorder, Agoraphobia; 20 vs. 8, P = 0.001) compared with ACS group. There was also a significant tendency in TTS patients to psychotropic medication use, substance abuse, and psychologist or psychiatrist consulting. However, there was no difference between the groups in previous stressful events and Type D personality. Moreover, the multivariate analysis showed that mood disorders were independently associated with TTS (OR 16.9, 95% CI, 2.2-127).

Conclusion: Our study demonstrated that pre-existing anxiety disorders and mostly mood disorders were significantly higher in TTS patients than in ACS group, suggesting the role of psychiatric disorders as possible pathophysiological substrate of TTS.

Keywords: Takotsubo syndrome; acute coronary syndrome; anxiety disorders; mood disorders; psychopathology.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Pathophysiological substrates of TTS and major results of the study.
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