{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:44:23Z","timestamp":1789778663815,"version":"4.0.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T00:00:00Z","timestamp":1657584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Takotsubo syndrome (TTS) is an emerging disease characterized by an acute and reversible myocardial dysfunction which may have an influence on clinical status and prognosis. Despite extensive research, its pathophysiology has not been completely elucidated; among other hypothesis, a heart-brain interaction has been proposed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The aim of this study was to assess the impact of psychiatric disorders and of some personality types on the pathogenesis of TTS. We conducted a retrospective observational case-control study. We enrolled a total of 50 patients, 25 with a previous diagnosis of TTS and 25 patients with a history of acute coronary syndrome (ACS), that underwent a comprehensive lifetime psychiatric assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found no significant difference between TTS and ACS patients in cardiovascular risk profile. The frequency of lifetime psychiatric disorders was significantly greater in TTS. In particular, in the univariate analysis, TTS group showed a higher prevalence of mood disorders (Major Depressive Disorder, Bipolar Disorder, Dysthymia; 16 vs. 2,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) and anxiety disorder (Generalized Anxiety Disorder, Panic Disorder, Agoraphobia; 20 vs. 8,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001) compared with ACS group. There was also a significant tendency in TTS patients to psychotropic medication use, substance abuse, and psychologist or psychiatrist consulting. However, there was no difference between the groups in previous stressful events and Type D personality. Moreover, the multivariate analysis showed that mood disorders were independently associated with TTS (OR 16.9, 95% CI, 2.2\u2013127).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study demonstrated that pre-existing anxiety disorders and mostly mood disorders were significantly higher in TTS patients than in ACS group, suggesting the role of psychiatric disorders as possible pathophysiological substrate of TTS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2022.925459","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T01:23:07Z","timestamp":1657588987000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Pre-existing Psychiatric Morbidity Is Strongly Associated to Takotsubo Syndrome: A Case-Control Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Gino","family":"Pozzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"D'Amario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Princi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Ciliberti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Irano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Velia","family":"Simone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Crea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonarda","family":"Galiuto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2426","DOI":"10.1161\/CIRCULATIONAHA.116.027121","article-title":"Pathophysiology of Takotsubo syndrome","volume":"135","author":"Pelliccia","year":"2017","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1093\/eurheartj\/ehy076","article-title":"International expert consensus document on Takotsubo syndrome (part i): clinical characteristics, diagnostic criteria, and pathophysiology","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1253\/circj.71.1092","article-title":"Coronary artery disease in takotsubo cardiomyopathy","volume":"71","author":"Haghi","year":"2007","journal-title":"Circ J."},{"key":"B4","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/S0735-1097(01)01316-X","article-title":"Angina Pectoris-Myocardial Infarction Investigations in Japan Transient left ventricular apical ballooning without coronary artery stenosis: a novel heart syndrome mimicking acute myocardial infarction Angina Pectoris-Myocardial Infarction Investigations in Japan","volume":"38","author":"Tsuchihashi","year":"2001","journal-title":"J Am Coll Cardiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1056\/NEJMoa1406761","article-title":"Clinical features and outcomes of Takotsubo (stress) cardiomyopathy","volume":"373","author":"Templin","year":"2015","journal-title":"N Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1002\/ejhf.494","article-title":"Long-term excess mortality in takotsubo cardiomyopathy: predictors, causes and clinical consequences","volume":"18","author":"Stiermaier","year":"2016","journal-title":"Eur J Heart Fail."},{"key":"B7","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1056\/NEJMoa043046","article-title":"Neurohumoral features of myocardial stunning due to sudden emotional stress","volume":"352","author":"Wittstein","year":"2005","journal-title":"N Engl J Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/ncpcardio1066","article-title":"Stress (Takotsubo) cardiomyopathy\u2013a novel pathophysiological hypothesis to explain catecholamine-induced acute myocardial stunning","volume":"5","author":"Lyon","year":"2008","journal-title":"Nat Clin Pract Cardiovasc Med."},{"key":"B9","first-page":"56","article-title":"Tako-tsubo like left ventricular dysfunction due to multivessel coronary spasm","volume-title":"Clinical Aspect of Myocardial Injury: From Ischaemia to Heart Failure. 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