Brain-heart Interactions in Tako-Tsubo Cardiomyopathy and Cardiac Syndrome X:

NCT ID: NCT02759341

Last Updated: 2017-11-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-29

Study Completion Date

2017-11-30

Brief Summary

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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.

Detailed Description

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Conditions

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Takotsubo Cardiomyopathy Cardiac X Syndrome Acute Myocardial Infarction

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Cardiac X Syndrome (CSX)

patients with Cardiac X Syndrome (CSX), according to the diagnostic criteria previously proposed by Lanza (Lanza, Heart. 2007)

Group Type OTHER

Manual for the Assessment and Documentation of Psychopathology (AMDP 8)

Intervention Type OTHER

Million Clinical Multiaxial Inventory 3 (MCMI-III)

Intervention Type OTHER

State-Trait Anxiety Inventory form Y (STAI-Y)

Intervention Type OTHER

SF-36 Health-Related Quality of Life

Intervention Type OTHER

Blood oxygenation level dependent- functional Magnetic Resonance Imaging (BOLD-fMRI)

Intervention Type OTHER

Takotsubo Cardiomyopathy (TTC)

Tako-Tsubo Cardiomyopathy (TTC), according to Mayo diagnostic criteria at least six months after the event. (Prasad A, et al. Am Heart J. 2008)

Group Type OTHER

Manual for the Assessment and Documentation of Psychopathology (AMDP 8)

Intervention Type OTHER

Million Clinical Multiaxial Inventory 3 (MCMI-III)

Intervention Type OTHER

State-Trait Anxiety Inventory form Y (STAI-Y)

Intervention Type OTHER

SF-36 Health-Related Quality of Life

Intervention Type OTHER

Blood oxygenation level dependent- functional Magnetic Resonance Imaging (BOLD-fMRI)

Intervention Type OTHER

Acute myocardial infarction (AMI)

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. (Thygesen K, et al. Eur Heart J. 2012)

Group Type OTHER

Manual for the Assessment and Documentation of Psychopathology (AMDP 8)

Intervention Type OTHER

Million Clinical Multiaxial Inventory 3 (MCMI-III)

Intervention Type OTHER

State-Trait Anxiety Inventory form Y (STAI-Y)

Intervention Type OTHER

SF-36 Health-Related Quality of Life

Intervention Type OTHER

Blood oxygenation level dependent- functional Magnetic Resonance Imaging (BOLD-fMRI)

Intervention Type OTHER

Interventions

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Manual for the Assessment and Documentation of Psychopathology (AMDP 8)

Intervention Type OTHER

Million Clinical Multiaxial Inventory 3 (MCMI-III)

Intervention Type OTHER

State-Trait Anxiety Inventory form Y (STAI-Y)

Intervention Type OTHER

SF-36 Health-Related Quality of Life

Intervention Type OTHER

Blood oxygenation level dependent- functional Magnetic Resonance Imaging (BOLD-fMRI)

Intervention Type OTHER

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Swiss Heart Foundation

OTHER

Sponsor Role collaborator

Ospedale San Giovanni Bellinzona

OTHER

Sponsor Role lead

Responsible Party

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Mattia Cattaneo

M.D.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mattia Cattaneo, MD

Role: PRINCIPAL_INVESTIGATOR

Ospedale San Giovanni Bellinzona

Augusto Gallino, MD

Role: STUDY_CHAIR

Ospedale San Giovanni Bellinzona

Locations

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Ospedale Regionale di Bellinzona e Valli - Ospedale San Giovanni Bellinzona

Bellinzona, Canton Ticino, Switzerland

Site Status

Countries

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Switzerland

References

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Lanza GA. Cardiac syndrome X: a critical overview and future perspectives. Heart. 2007 Feb;93(2):159-66. doi: 10.1136/hrt.2005.067330. Epub 2006 Jan 6.

Reference Type BACKGROUND
PMID: 16399854 (View on PubMed)

Prasad A, Lerman A, Rihal CS. Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction. Am Heart J. 2008 Mar;155(3):408-17. doi: 10.1016/j.ahj.2007.11.008. Epub 2008 Jan 31.

Reference Type BACKGROUND
PMID: 18294473 (View on PubMed)

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD; Writing Group on the Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction; Thygesen K, Alpert JS, White HD, Jaffe AS, Katus HA, Apple FS, Lindahl B, Morrow DA, Chaitman BA, Clemmensen PM, Johanson P, Hod H, Underwood R, Bax JJ, Bonow RO, Pinto F, Gibbons RJ, Fox KA, Atar D, Newby LK, Galvani M, Hamm CW, Uretsky BF, Steg PG, Wijns W, Bassand JP, Menasche P, Ravkilde J, Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Simoons ML, Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G, Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D, Smith SC, Hu D, Lopez-Sendon JL, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S; ESC Committee for Practice Guidelines (CPG). Third universal definition of myocardial infarction. Eur Heart J. 2012 Oct;33(20):2551-67. doi: 10.1093/eurheartj/ehs184. Epub 2012 Aug 24. No abstract available.

Reference Type BACKGROUND
PMID: 22922414 (View on PubMed)

Cattaneo MM, Pravata E, Provenzi M, Moccetti M, Kaelin A, Sudano I, Biasucci L, Gallino C, Limoni C, Calanchini C, Gallino A, Crea F, Cattaneo M. Role of the central autonomic nervous system intrinsic functional organisation and psychosocial factors in primary microvascular angina and Takotsubo syndrome. Open Heart. 2020 Jul;7(2):e001315. doi: 10.1136/openhrt-2020-001315.

Reference Type DERIVED
PMID: 32727853 (View on PubMed)

Other Identifiers

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2016-00015

Identifier Type: OTHER

Identifier Source: secondary_id

CE 3015

Identifier Type: -

Identifier Source: org_study_id