Role of the central autonomic nervous system intrinsic functional organisation and psychosocial factors in primary microvascular angina and Takotsubo syndrome
| Autor: | Micol Provenzi, Emanuele Pravata, Camilla Gallino, Magdalena Maria Cattaneo, Marco Moccetti, Filippo Crea, Carlo Calanchini, Costanzo Limoni, Alain Kaelin, M. Cattaneo, Isabella Sudano, Luigi M. Biasucci, Augusto Gallino |
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| Přispěvatelé: | University of Zurich |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
030204 cardiovascular system & hematology Neuropsychological Tests 0302 clinical medicine endothelial function Medicine Myocardial infarction Prospective Studies Microvascular Angina Cerebral Cortex Brain Mapping Pain Perception syndrome X Magnetic Resonance Imaging autonomic regulation Psychosocial Functioning Mental Health 10209 Clinic for Cardiology Anxiety Female medicine.symptom Cardiology and Cardiovascular Medicine Psychosocial Millon Clinical Multiaxial Inventory medicine.medical_specialty cardiomyopathy apical Dysfunctional family 610 Medicine & health Autonomic Nervous System Stress 11171 Cardiocentro Ticino 03 medical and health sciences Takotsubo Cardiomyopathy Internal medicine Humans Aged Resting state fMRI business.industry medicine.disease Mental health Special Populations Autonomic nervous system Cross-Sectional Studies Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE Psychological microvascular business 030217 neurology & neurosurgery Stress Psychological |
| Zdroj: | Open Heart |
| Popis: | Introduction and objectiveDysfunctional central autonomic nervous system network (CAN) at rest may result in aberrant autonomic responses to psychosocial stressors. We hypothesised that patients with primary microvascular angina (MVA) or Takotsubo syndrome (TTS) would exhibit a peculiar functional organisation of the CAN, potentially associated with psychological patterns.MethodsPatients underwent a psychosocial evaluation: a clinical diagnostic interview, Millon Clinical Multiaxial Inventory III, State-Trait Anxiety Inventory form Y and Short Form 36 Health Survey (SF-36). The strength of intrinsic functional connectivity (FC) between various nodes of the CAN was investigated using cerebral resting state functional MRI (RS-fMRI).ResultsWe evaluated 50 (46 women) stable patients: 16 patients with MVA, 17 patients with TTS and 17 patients with previous acute myocardial infarction (AMI). Compared with AMI, patients with MVA showed a lower (higher impairment) SF-36 Body-Pain score (p 0.046) and a higher SF-36 Mental-Health score (p 0.039). Patients with TTS showed the strongest FC between two nodes of the CAN (sympathetic midcingulate cortex and parasympathetic primary motor area) (F 6.25, p 0.005) using RS-fMRI.ConclusionsThe study implements an innovative collaborative research among cardiologists, neuroscientists and psychiatrists (‘Neuro-psycho-heart Team’). MVA showed a discrepancy between the highest level of self-reported body pain and the best mental health score, which might suggest a mechanism of somatisation. TTS exhibited an increased functional integration between two areas of the CAN involved in interoceptive pain awareness and negative emotional status. We implemented an innovative research collaboration among cardiologists, neuroscientists and psychiatrists. These data are hypothesis generating and suggest potential prospective investigations on pathophysiology and implementation of psychotherapy and stress-reducing techniques as therapeutic strategies.Trial registration numberNCT02759341. |
| Databáze: | OpenAIRE |
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