ArticlePloS one2014
Direct evidences for sympathetic hyperactivity and baroreflex impairment in Tako Tsubo cardiopathy.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04695587 (The Role of Sympathetic Tone Regarding the Anatomical and Functional Recovery of the Left Ventricle in TakoTsubo Syndrome), which is not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Role of Sympathetic Tone Regarding the Anatomical and Functional Recovery of the Left Ventricle in TakoTsubo Syndrome
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
- The role of central autonomic nervous system dysfunction in Takotsubo syndrome: a systematic review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2022Pooled it
- Sympathetic nerve activity and response to physiological stress in Takotsubo syndrome.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Trial
- Neurocardiology: Brain-Heart Interactions in the Heart.MedComm · 2026Review
- The Role of Inflammation in Takotsubo Syndrome: From Pathogenic Pathways To Imaging Insights and Therapeutic Perspectives.Current cardiology reports · 2026Review
- Development and validation of a nomogram prediction model for cardiovascular comorbidities in COPD patients based on hypertension.Frontiers in medicine · 2026Article
- Takotsubo syndrome: Unraveling the mystery behind its triggers (Review).International journal of molecular medicine · 2025Review
- Prognostic significance of myocardial ischaemia during exercise echocardiography in the absence of angiographic evidence of obstructive coronary disease.European heart journal. Imaging methods and practice · 2025Article
- Takotsubo syndrome linked to paroxysmal sympathetic hyperactivity as a postoperative complication after brain tumor removal: a case report and literature review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Review
- Takotsubo pathophysiology and complications: what we know and what we do not know.Heart failure reviews · 2024Review
- Exploratory Review of the Takotsubo Syndrome and the Possible Role of the Psychosocial Stress Response and Inflammaging.Biomolecules · 2024Review
- Takotsubo syndrome: unravelling the enigma of the broken heart syndrome?-a narrative review.Cardiovascular diagnosis and therapy · 2023Review
- Autonomic control of ventricular function in health and disease: current state of the art.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Review
- Ischemia and no obstructive coronary arteries (INOCA): A narrative review.Atherosclerosis · 2022Review
- Update of Takotsubo cardiomyopathy: Present experience and outlook for the future.International journal of cardiology. Heart & vasculature · 2022Review
- Metabolic remodeling in takotsubo syndrome.Frontiers in cardiovascular medicine · 2022Review
- Machine learning powered tools for automated analysis of muscle sympathetic nerve activity recordings.Physiological reports · 2021Article
- CORP: Standardizing methodology for assessing spontaneous baroreflex control of muscle sympathetic nerve activity in humans.American journal of physiology. Heart and circulatory physiology · 2021Article
- Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 1-Pathophysiology and Diagnosis.Journal of clinical medicine · 2021Review
- Oxidative Stress in Takotsubo Syndrome-Is It Essential for an Acute Attack? Indirect Evidences Support Multisite Impact Including the Calcium Overload-Energy Failure Hypothesis.Frontiers in cardiovascular medicine · 2021Article
- Takotsubo Syndrome: Clinical Manifestations, Etiology and Pathogenesis.Current cardiology reviews · 2021Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe exact pathophysiology of Tako-Tsubo cardiomyopathy (TTC) remains unknown but a role for sympathetic hyperactivity has been suggested. Up to now, no direct evidence of sympathetic nerve hyperactivity has been established nor involvement of sympathetic baroreflex identified. The aim of our study was to determine, by direct sympathetic nerve activity (SNS) recording if sympathetic nervous system activity is increased and spontaneous baroreflex control of sympathetic activity reduced in patients with TTC.
methodsWe included 13 patients who presented with TTC and compared their SNS activity and spontaneous baroreflex control of sympathetic activity with that of 13 control patients with acutely decompensated chronic heart failure. SNS activity was evaluated by microneurography, a technique assessing muscle sympathetic nerve activity (MSNA). Spontaneous baroreflex control of sympathetic activity was evaluated as the absolute value of the slope of the regression line representing the relationship between spontaneous diastolic blood pressure values and concomitant SNS activity. Control patients were matched for age, sex, left ventricular ejection fraction and creatinine clearance.
resultsThe mean age of the patients with TTC was 80 years, all patients were women. There were no significant differences between the two groups of patients for blood pressure, heart rate or oxygen saturation level. TTC patients presented a significant increase in sympathetic nerve activity (MSNA median 63.3 bursts/min [interquartile range 61.3 to 66.0] vs median 55.7 bursts/min [interquartile range 51.0 to 61.7]; p = 0.0089) and a decrease in spontaneous baroreflex control of sympathetic activity compared to matched control patients (spontaneous baroreflex control of sympathetic activity median 0.7%burst/mmHg [interquartile range 0.4 to 1.9] vs median 2.4%burst/mmHg [interquartile range 1.8 to 2.9]; p = 0.005).
conclusionsWe report for the first time, through direct measurement of sympathetic nerve activity, that patients with TTC exhibit elevated SNS activity associated with a decrease in spontaneous baroreflex control of sympathetic activity. These data may explain the pathophysiology and clinical presentation of patient with TTC.
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