Sympathetic and Vascular Function in Takotsubo Syndrome
- Conditions
- Takotsubo Cardiomyopathy
- Interventions
- Drug: Saline
- Registration Number
- NCT05768542
- Lead Sponsor
- Danderyd Hospital
- Brief Summary
The primary objective of this prospective, observational study is to compare muscle sympathetic nerve activity at rest and during stress between female patients with Takotsubo syndrome and healthy, matched volunteers.
* Do Takotsubo patients have an increased sympathetic nerve activity compared to controls?
* Do Takotsubo patients have an exaggerated sympathetic nerve activity response to stress?
* Does the sympathetic nerve activity response to stress in Takotsubo change after receiving the beta blocking agent metoprolol?
Participants will be examined with muscle sympathetic nerve activity recording in the peroneal nerve at rest and during cold pressor test. After intravenous injection with beta blocking agent (metoprolol) or placebo (saline) in a 1:1 randomized fashion, muscle sympathetic nerve recording at rest and during stress will be repeated.
- Detailed Description
Female Takotsubo patients included in the SAFT (sympathetic and vascular function in Takotsubo syndrome) study will be invited to undergo microneurography recording of muscle sympathetic nerve activity (MSNA) at rest and during stress one week to two month after study inclusion. Responses to stress with and without the commonly used betablocking agent metoprolol will be compares.
Microneurography will be performed in the morning after a light caffeine-free breakfast with the subject supine and awake. Any medication with a beta blocking agent will be discontinued 24 hours prior to examination. MSNA will be recorded by inserting a tungsten electrode into the sympathetic nerve fibres of the peroneal nerve, with simultaneous blood pressure and heart rate monitoring.
MSNA recording will then continue during stress induced by placing one of the subjects hand in ice-cold water for 90 seconds (cold pressor test).
After intravenous injection with beta blocking agent (metoprolol) or placebo (saline) in a 1:1 randomized fashion, MSNA recording at rest and during stress will be repeated.
Age- and gender-matched healthy volunteers will be recruited as controls and examined similarly with microneurography at rest and during stress.
MSNA recordings will be amplified, computerized and saved for further analyses. MSNA will be quantified as burst incidence (burst per 100 heartbeats), burst frequence (bursts per minute) and relative median burst amplitude (%). MSNA activity will be compared between Takotsubo patients and controls and before and after betablockade in Takotsubo patients.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 31
For patients:
- Diagnosis of Takotsubo cardiomyopathy
For Controls:
- Matching age with Takotsubo patients
- Signed informed consent
- Coronary anathomy precluding intracoronary investigations
- Severe obstructive pulmonary disease
- Kidney failure with estimated glomerular filtration rate < 30 ml/min/m2
- Active malignancy
- Pericarditis
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Takotsubo Control Metoprolol Injection Patients with Takotsubo receiving betablockade Takotsubo Intervention Saline Patients with Takotsubo receiving placebo
- Primary Outcome Measures
Name Time Method Resting MSNA During 5 minutes rest Muscle sympathetic nerve activity during rest
MSNA increase during CPT During the last 60 seconds of the CPT Muscle sympathetic nerve activity increase during cold pressor test
- Secondary Outcome Measures
Name Time Method MSNA increase during CPT after intervention During the last 60 seconds of the CPT Muscle sympathetic nerve activity increase during cold pressor test after betablockade
Hemodynamic changes during CPT During the last 60 seconds of the CPT Change in blood pressure