The mechanism underlying the so-called 'broken-heart syndrome' has been identified by scientists.
Called Tako-Tsubo syndrome, or stress-induced cardiomyopathy, it is a rare disease, which at first used to be confused with the far more common (and dangerous) cardiac infarction or heart attack.
Many have also defined it as the "broken heart disease"- it affects mostly women in post menopause period, when they are no longer protected by the estrogen hormones, and it is associated with strong emotional stress, like a bereavement, in 80 percent of the cases. This is the reason why it is often associated with a broken heart.
Led by Filippo Crea, researchers have now identified the mechanism underlying this peculiar pathology.
"In 80 percent of the patients, symptoms disappear spontaneously after a couple of weeks, leaving no trace behind, whilst in the other cases the damage persists. The fact is that the damage caused by this syndrome is in the heart but not in the coronaries. What we have tried to explain is the mechanism which leads to the onset of these symptoms," said Crea.
To perform the analysis, researchers studied fifteen women aged on average 68 for a month.
And thanks to this study, they could identify for the first time the phisiopathological mechanism of the disease.
"We concentrated on the apical region of the heart because that is the area where the dysfunction is localized. Due to this, the heart takes on the characteristic shape of an air balloon, or - as the Japanese observed - of a local octopus trap. The Tako-Tsubo is as a matter of fact the name of this pot in Japanese," explained first author Leda Galiuto.
The hypothesis the researchers developed is that the mechanism, which influences the dysfunction, resides in the spasm of the small coronary vessels, the so-called coronary microcirculation.
"To prove our hypothesis we used the myocardial contrast echography, a method we pioneered and which allows us to study the coronary microcirculation in a selective, safe and cheap way at the patient's bedside," said Crea.
"The microcirculation plays an important role in cardiac diseases and the intense vasoconstriction of these small vessels cannot normally be noticed in a coronarography," he added.
Researchers have also been able to demonstrate that this microvascular spasm is reversible and, once over the acute phase, the microvascular dysfunction causing the symptoms is also resolved.
"Usually patients are not left with any damage, because the lowering of the blood input is sufficiently serious to prevent the heart from contracting properly, and hence the balloon-like shape, but not enough to determine the death of blood cells, which is what normally happens in an infarction", concluded Crea.
The study has been published in the European Heart Journal, of the European Society of Cardiology.