Sympathetic Heart Innervation in Patients With Tako-Tsubo Cardiomyopathy
Status:
Completed
Trial end date:
2016-01-01
Target enrollment:
Participant gender:
Summary
Stress (tako-tsubo) cardiomyopathy (SC) is a rapidly reversible form of acute heart failure
reported to be triggered by stressful events and associated with a distinctive left
ventricular (LV) contraction pattern.
SC mimics acute coronary syndrome and is accompanied by reversible left ventricular apical
ballooning in the absence of angiographically significant coronary artery stenosis.
sympathetic activity dysfunction appears to play a very important role in the pathophysiology
of takotsubo cardiomyopathy.
In most cases, myocardial scintillography with 123Imetaiodobenzylguanidine (MIBG) showed
altered captation of the radiotracer in several heart segments. In particular, the apical
myocardium has poor sympathetic innervations and an uptake reduction in MIBG tracer.
A hypothesis for this finding could be that the intense discharge of adrenalin, acting on
heart segment with different and abnormal innervation, may produce a transient heart failure
characterized by a particular shape of the left ventricle.
While studies have shown that heterogeneous MIBG distribution, decreased MIBG uptake and
increased norepinephrine content were completely prevented by α-lipoic acid or by L-acetyl
carnitine administrations in diabetic cardiomyopathy, no studies have examined the effects of
these therapies on tako-tsubo cardiomyopathy.
On this basis, the investigators study will evaluate whether the dysfunction of adrenergic
cardiac innervation, evaluated by MIBG, persist after previous experience of transient
stress-induced cardiac dysfunction. Moreover, the investigators will assess whether the
medications that restore sympatho-vagal alterations in diabetic cardiomyopathy, such as
α-lipoic acid and L-acetyl carnitine, will improve the adrenergic cardiac innervation, in
patients with SC.
Phase:
Phase 4
Details
Lead Sponsor:
Second University of Naples University of Campania "Luigi Vanvitelli"