elationship Between Brain Death and Takotsubo Cardiomyopathy: A Comprehensive Neurocardiogenic Approach Focused on Donation of the Heart.
Main Article Content
Abstract
This analysis explores the relationship between brain death and Takotsubo cardiomyopathy (TT), also known as "broken heart syndrome." Both conditions share an exaggerated response of the autonomic nervous system, generating an overload of catecholamines that affect the myocardium and can cause severe complications. The study highlights how brain death induces ventricular dysfunction, like the patterns observed in TT, and highlights the potential reversibility of these dysfunctions, with important implications for optimizing the use of donor hearts in circulatory arrest. In addition, autonomic modulation is addressed as a promising therapeutic avenue to improve prognosis and reduce adverse events. The work underscores the need for innovative approaches to clinical management and future research that facilitates the development of therapeutic strategies targeting autonomic activity and inflammation.
Keywords:
Takotsubo, brain death, heart transplantation, cardiac dysfunction, ischemic heart disease, cerebral vascular event
Article Details
How to Cite
CAREAGA-REYNA, Guillermo; ZETINA-TUN, Hugo J..
elationship Between Brain Death and Takotsubo Cardiomyopathy: A Comprehensive Neurocardiogenic Approach Focused on Donation of the Heart..
Medical Research Archives, [S.l.], v. 12, n. 12, dec. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6023>. Date accessed: 06 jan. 2025.
doi: https://doi.org/10.18103/mra.v12i12.6023.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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15. Thuong M, Ruiz A, Evrard P, Kuiper M, Boffa C, Akhtar MZ et al. New classification of donation after circulatory death donors definition and terminology. Transpl Int 2016; 29:749–759.
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18. Redfors B., Shao Y., Omerovic E. Stress-induced cardiomyopathy in a patient with chronic spinal cord transection at the level of C5: endocrinologically mediated catecholamine toxicity. Int J Cardiol 2013; 159: e61–e62.
19. Ravi Y, Campagna R, Rosas PC, Essa E, Hasan AK, Higgins RS, et al. Successful heart transplantation using a donor heart afflicted by Takotsubo cardiomyopathy. Proc Bayl Univ Med Cent 2016; 29: 73-74.
20. Celeski M, Nusca A, De Luca VM, Antonelli G, Cammalleri V, Melfi R, et al. Takotsubo Syndrome and Coronary Artery Disease: ¿Which Came First-The Chicken or the Egg? J. Cardiovasc. Dev. Dis. 2024, 11(2), 39; https://doi.org/10.3390/jcdd11020039
21. Behnes M, Baumann S, Borggrefe M, Haghi D. Biventricular Takotsubo cardiomyopathy in a heart transplant recipient. Circulation 2013; 128: e62-63.
22. Perez Lopez S, Otero Hernandez J, Vazquez Moreno N, Escudero Augusto D, Alvarez Menéndez F, Astudillo Gonzalez A. Brain death effects on catecholamine levels and subsequent cardiac damage assessed in organ donors. J Heart Lung Transplant 2009; 28(8): 815-820.
23. Redfors B, Råmunddal T, Oras J, Karason K, Ricksten SE, Dellgren G, et al. Successful heart transplantation from a donor with takotsubo syndrome. Int J Cardiol 2015; 195: 82-84.
24. De Giorgi A, Fabbian F, Guarino M, Spampinato MD, Boari B, Cappadona R, et al. Takotsubo syndrome and heart transplantation. A Reciprocate Liaison? Heart and Mind 2017; 1(4): 123-128.
25. Pelliccia F, Moretti A, Marazzi G, Gaudio C. Dying from takotsubo syndrome at a young age. Adv Interv Cardiol 2018; 14(3), 221-224.
2. Prasad A, Dangas G, Srinivasan M, Yu J, Gersh BJ, Mehran R, et al. Incidence and angiographic characteristics of patients with apical ballooning syndrome (takotsubo/stress cardiomyopathy) in the HORIZONS-AMI trial: an analysis from a multicenter, international study of ST-elevation myocardial infarction. Catheter Cardiovasc Interv. 2014; 83: 343–348.
3. Redfors B, Vedad R, Angerås O, Råmunddal T, Petursson P, Haraldsson I, et al. Mortality in takotsubo syndrome is similar to mortality in myocardial infarction - A report from the SWEDEHEART registry. Int J Cardiol. 2015; 185: 282–289.
4. Schino S, Bezzeccheri A, Russo A, Bonanni M, Cosma J, Sangiorgi G et al. Takotsubo Syndrome: The Secret Crosstalk between Heart and Brain. Rev. Cardiovasc. Med. 2023; 24 (1): 19. https://doi.org/10.31083/j.rcm2401019
5. Leiva Abanto C, Medina Palomino F, Anchante Hernández H, Dueñas Carvajal R. Takotsubo Syndrome: cardiovascular complication of stroke. Arch Peru Cardiol Cir Cardiovasc.2022; 3(4):204-209. doi: 10.47487/apcyccv.v3i4.235.
6. Singh T, Khan H, Gamble DT, Scally C, Newby DE, Dawson D. (2022). Takotsubo syndrome: Pathophysiology, emerging concepts, and clinical implications. Circulation 2022; 145:1002-1019.
7. Berman M, Ali A, Ashley E, Freed D, Clarke K, Tsui S et al. (2010). Is stress cardiomyopathy the underlying cause of ventricular dysfunction associated with brain death? J Heart Lung Transplant 2010; 29(9): 957-965.
8. El-Battrawy I, Borggrefe M, Akin I. (2018). Myocardial dysfunction following brain death. J Am Coll Cardiol 2018; 71(3): 363-369.
9. Fan X, Yang G, Kowitz J, Akin I, Zhou X, El-Battrawy I. Takotsubo syndrome: Translational implications and pathomechanisms. Int. J. Mol. Sci. 2022, 23, 1951. https://doi.org/10.3390/ijms23041951
10. Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. N Engl J Med 2015; 373(9): 929-938.
11. Khan H, Gamble DT, Rudd A, Mezincescu AM, Abbas H, Noman A et al. (2023). Structural and functional brain changes in acute Takotsubo syndrome. JACC: Heart Failure 2023; 11(3): 307-317.
12. Silva AR, Magalhães R, Arantes C, Silva Moreira P, Rodrigues M, Marques P et al. Brain functional connectivity is altered in patients with Takotsubo syndrome. Scientific Reports 2019; 9(4187) https://doi.org/10.1038/s41598-019-40695-3
13. European Heart Journal. (2024). Advances in neurocardiology: Brain-heart interactions in stress-induced cardiomyopathy. Eur Heart J, 42(19), 1909-1923.
14. Groba Marco M, Galvan Ruiz M, Cabrera Santana M, Romero Lujan JL, Portela Torron F, Santana Ortega L et al. Expanding heart donor pool with a broken heart. Transplantation 2023; 107(5): e152-e159.
15. Thuong M, Ruiz A, Evrard P, Kuiper M, Boffa C, Akhtar MZ et al. New classification of donation after circulatory death donors definition and terminology. Transpl Int 2016; 29:749–759.
16. Mohamedali B, Bhat G, Tatooles A, Zelinger A. Neurogenic stress cardiomyopathy in heart donors. J Card Fail 2014; 20: 207-211.
17. Wybraniec M, Mizia-Stec K, Krzych Ł. (2014). Neurocardiogenic injury in subarachnoid hemorrhage: A wide spectrum of catecholamin-mediated brain-heart interactions. Cardiol J 2014; 21(3): 220-228.
18. Redfors B., Shao Y., Omerovic E. Stress-induced cardiomyopathy in a patient with chronic spinal cord transection at the level of C5: endocrinologically mediated catecholamine toxicity. Int J Cardiol 2013; 159: e61–e62.
19. Ravi Y, Campagna R, Rosas PC, Essa E, Hasan AK, Higgins RS, et al. Successful heart transplantation using a donor heart afflicted by Takotsubo cardiomyopathy. Proc Bayl Univ Med Cent 2016; 29: 73-74.
20. Celeski M, Nusca A, De Luca VM, Antonelli G, Cammalleri V, Melfi R, et al. Takotsubo Syndrome and Coronary Artery Disease: ¿Which Came First-The Chicken or the Egg? J. Cardiovasc. Dev. Dis. 2024, 11(2), 39; https://doi.org/10.3390/jcdd11020039
21. Behnes M, Baumann S, Borggrefe M, Haghi D. Biventricular Takotsubo cardiomyopathy in a heart transplant recipient. Circulation 2013; 128: e62-63.
22. Perez Lopez S, Otero Hernandez J, Vazquez Moreno N, Escudero Augusto D, Alvarez Menéndez F, Astudillo Gonzalez A. Brain death effects on catecholamine levels and subsequent cardiac damage assessed in organ donors. J Heart Lung Transplant 2009; 28(8): 815-820.
23. Redfors B, Råmunddal T, Oras J, Karason K, Ricksten SE, Dellgren G, et al. Successful heart transplantation from a donor with takotsubo syndrome. Int J Cardiol 2015; 195: 82-84.
24. De Giorgi A, Fabbian F, Guarino M, Spampinato MD, Boari B, Cappadona R, et al. Takotsubo syndrome and heart transplantation. A Reciprocate Liaison? Heart and Mind 2017; 1(4): 123-128.
25. Pelliccia F, Moretti A, Marazzi G, Gaudio C. Dying from takotsubo syndrome at a young age. Adv Interv Cardiol 2018; 14(3), 221-224.