Acute Myocardial Infarction, Cardiac X Syndrome, Takotsubo Cardiomyopathy
Conditions
Brief summary
The Tako-Tsubo Cardiomyopathy (TTC) and the Cardiac Syndrome X (CSX) are respectively acute and chronic heart diseases, which mimic myocardial infarction and stable angina pectoris without alterations of large coronary vessels. The causes and the most appropriate and best treatment for these diseases have not been yet clarified, but there are indications, that mental and psychosocial aspects may also contribute to these two diseases. So far, there is no study, which has comprehensively evaluated the interactions between mind and heart in these two conditions. The purpose of this study is to search for possible differences in mental activity, response to stressful events and function of specific areas of the brain deeply involved in relation between mind and heart. 45 subjects will be recruited and divided equally into: patients with CSX, patients with TTC (at least 6 months ago) and patients with previous acute myocardial infarction (at least 6 months ago). All participants will undergo a clinical interview and several questionnaires that assess various mental functions, the stress response and the quality of life. In addition, in a separate visit the participants will undergo a Magnetic Resonance Imaging without contrast medium that helps to assess function of specific areas of the brain.
Interventions
OTHERManual for the Assessment and Documentation of Psychopathology (AMDP 8)
OTHERMillion Clinical Multiaxial Inventory 3 (MCMI-III)
OTHERState-Trait Anxiety Inventory form Y (STAI-Y)
OTHERSF-36 Health-Related Quality of Life
OTHERBlood oxygenation level dependent- functional Magnetic Resonance Imaging (BOLD-fMRI)
Sponsors
Swiss Heart Foundation
Ospedale San Giovanni Bellinzona
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Group A. 15 patients with Cardiac X Syndrome (CSX), according to the diagnostic criteria previously proposed by Lanza et al. * Group B. 15 patients with Tako-Tsubo Cardiomyopathy (TTC), according to Mayo diagnostic criteria at least 6 months after being hospitalized or diagnosed with TTC. * Group C (control group). 15 prospectively enrolled patients with previous Type 1, 4a, 4b myocardial infarction (ST-segment elevation acute myocardial infarction \[STEMI\] and Non ST-segment elevation acute myocardial infarction \[NSTEMI\] acute coronary syndrome \[ACS\] with significant ≥70% coronary stenosis) at least six months after the event. Acute myocardial infarction will be defined according to the third universal definition of myocardial infarction.
Exclusion criteria
* Refused consent * Unable to participate or provide written informed consent * Short-term survival (\<1 year) * Acute or decompensated medical conditions * Acute neurological or psychiatric diseases * Absence of sinus rhythm or frequent ectopic beats * History of severe lung, liver, kidney or autoimmune diseases * Any contraindication to MRI
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Difference in BOLD-fMRI intensity signal in CSX and TTC as compared to AMI patients | Baseline |
| Difference in BOLD-fMRI distribution signal in CSX and TTC as compared to AMI patients | Baseline |
Secondary
| Measure | Time frame |
|---|---|
| Difference in CSX and TTC AMDP 8 results as compared to AMI patients | Baseline |
| Difference in CSX and TTC MCMI-III results as compared to AMI patients | Baseline |
| Difference in CSX and TTC STAI-Y results as compared to AMI patients | Baseline |
| Difference in CSX and TTC SF-36 HRQOL results as compared to AMI patients | Baseline |
Countries
Switzerland
Outcome results
None listed