Anxiety disorders and stressful events in Takotsubo syndrome

Davide Lazzeroni; Matteo Bini; Paolo Castiglioni; Luca Moderato; Chiara Ciracì; Umberto Camaiora; Pietro Tito Ugolotti; Lorenzo Brambilla; Valerio Brambilla; Silvia Garibaldi; Letizia Paglialonga; Valentina Ziveri; Fabrizio Ugo; Nicola Gaibazzi; Paolo Coruzzi

doi:10.5603/CJ.a2017.0136

Anxiety disorders and stressful events in Takotsubo syndrome

Davide Lazzeroni, Matteo Bini, Paolo Castiglioni, Luca Moderato, Chiara Ciracì, Umberto Camaiora, Pietro Tito Ugolotti, Lorenzo Brambilla, Valerio Brambilla, Silvia Garibaldi, Letizia Paglialonga, Valentina Ziveri, Fabrizio Ugo, Nicola Gaibazzi, Paolo Coruzzi

Fondazione Don Carlo Gnocchi Onlus

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Anxiety disorders are more common in Takotsubo syndrome (TS) than in acute coronary syndrome patients. Theaim of this study was to investigate whether pre-existing anxiety disorders predispose to TS triggered by exclusively emotional stressful events.

METHODS: Triggering events were compared in 58 TS patients with and without pre-existing anxiety disorders; clinical, electrocardiographic and echocardiographic data were also collected.

RESULTS: Thirty-one (53%) patients had a previous history of anxiety disorders. The exclusively emotional stressful event-rate was higher in TS patients with pre-existing anxiety disorder (74% vs. 30%, p = 0.001), while TS caused by an undetermined trigger were significantly higher in patients without anxiety disorders (33% vs. 10%, p = 0.027). Moreover, in TS patients without a previous history of anxiety disorders, a trend of higher prevalence of physical events was found (16% vs. 37%, p = 0.07).

CONCLUSIONS: In patients with pre-existing anxiety disorders, TS was predominantly triggered by exclusively emotional stressful events, thereby suggesting a possible relationship between anxiety and emotional cardiac frailty in TS patients.

Original language	English
Journal	Cardiology Journal
DOIs	https://doi.org/10.5603/CJ.a2017.0136
Publication status	E-pub ahead of print - Nov 23 2017

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Anxiety disorders and stressful events in Takotsubo syndrome. / Lazzeroni, Davide; Bini, Matteo; Castiglioni, Paolo; Moderato, Luca; Ciracì, Chiara; Camaiora, Umberto; Ugolotti, Pietro Tito; Brambilla, Lorenzo; Brambilla, Valerio; Garibaldi, Silvia; Paglialonga, Letizia; Ziveri, Valentina; Ugo, Fabrizio; Gaibazzi, Nicola; Coruzzi, Paolo.

In: Cardiology Journal, 23.11.2017.

Research output: Contribution to journal › Article › peer-review

Lazzeroni, Davide ; Bini, Matteo ; Castiglioni, Paolo ; Moderato, Luca ; Ciracì, Chiara ; Camaiora, Umberto ; Ugolotti, Pietro Tito ; Brambilla, Lorenzo ; Brambilla, Valerio ; Garibaldi, Silvia ; Paglialonga, Letizia ; Ziveri, Valentina ; Ugo, Fabrizio ; Gaibazzi, Nicola ; Coruzzi, Paolo. / Anxiety disorders and stressful events in Takotsubo syndrome. In: Cardiology Journal. 2017.

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title = "Anxiety disorders and stressful events in Takotsubo syndrome",

abstract = "BACKGROUND: Anxiety disorders are more common in Takotsubo syndrome (TS) than in acute coronary syndrome patients. Theaim of this study was to investigate whether pre-existing anxiety disorders predispose to TS triggered by exclusively emotional stressful events.METHODS: Triggering events were compared in 58 TS patients with and without pre-existing anxiety disorders; clinical, electrocardiographic and echocardiographic data were also collected.RESULTS: Thirty-one (53%) patients had a previous history of anxiety disorders. The exclusively emotional stressful event-rate was higher in TS patients with pre-existing anxiety disorder (74% vs. 30%, p = 0.001), while TS caused by an undetermined trigger were significantly higher in patients without anxiety disorders (33% vs. 10%, p = 0.027). Moreover, in TS patients without a previous history of anxiety disorders, a trend of higher prevalence of physical events was found (16% vs. 37%, p = 0.07).CONCLUSIONS: In patients with pre-existing anxiety disorders, TS was predominantly triggered by exclusively emotional stressful events, thereby suggesting a possible relationship between anxiety and emotional cardiac frailty in TS patients.",

author = "Davide Lazzeroni and Matteo Bini and Paolo Castiglioni and Luca Moderato and Chiara Cirac{\`i} and Umberto Camaiora and Ugolotti, {Pietro Tito} and Lorenzo Brambilla and Valerio Brambilla and Silvia Garibaldi and Letizia Paglialonga and Valentina Ziveri and Fabrizio Ugo and Nicola Gaibazzi and Paolo Coruzzi",

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AU - Lazzeroni, Davide

AU - Bini, Matteo

AU - Castiglioni, Paolo

AU - Moderato, Luca

AU - Ciracì, Chiara

AU - Camaiora, Umberto

AU - Ugolotti, Pietro Tito

AU - Brambilla, Lorenzo

AU - Brambilla, Valerio

AU - Garibaldi, Silvia

AU - Paglialonga, Letizia

AU - Ziveri, Valentina

AU - Ugo, Fabrizio

AU - Gaibazzi, Nicola

AU - Coruzzi, Paolo

PY - 2017/11/23

Y1 - 2017/11/23

N2 - BACKGROUND: Anxiety disorders are more common in Takotsubo syndrome (TS) than in acute coronary syndrome patients. Theaim of this study was to investigate whether pre-existing anxiety disorders predispose to TS triggered by exclusively emotional stressful events.METHODS: Triggering events were compared in 58 TS patients with and without pre-existing anxiety disorders; clinical, electrocardiographic and echocardiographic data were also collected.RESULTS: Thirty-one (53%) patients had a previous history of anxiety disorders. The exclusively emotional stressful event-rate was higher in TS patients with pre-existing anxiety disorder (74% vs. 30%, p = 0.001), while TS caused by an undetermined trigger were significantly higher in patients without anxiety disorders (33% vs. 10%, p = 0.027). Moreover, in TS patients without a previous history of anxiety disorders, a trend of higher prevalence of physical events was found (16% vs. 37%, p = 0.07).CONCLUSIONS: In patients with pre-existing anxiety disorders, TS was predominantly triggered by exclusively emotional stressful events, thereby suggesting a possible relationship between anxiety and emotional cardiac frailty in TS patients.

AB - BACKGROUND: Anxiety disorders are more common in Takotsubo syndrome (TS) than in acute coronary syndrome patients. Theaim of this study was to investigate whether pre-existing anxiety disorders predispose to TS triggered by exclusively emotional stressful events.METHODS: Triggering events were compared in 58 TS patients with and without pre-existing anxiety disorders; clinical, electrocardiographic and echocardiographic data were also collected.RESULTS: Thirty-one (53%) patients had a previous history of anxiety disorders. The exclusively emotional stressful event-rate was higher in TS patients with pre-existing anxiety disorder (74% vs. 30%, p = 0.001), while TS caused by an undetermined trigger were significantly higher in patients without anxiety disorders (33% vs. 10%, p = 0.027). Moreover, in TS patients without a previous history of anxiety disorders, a trend of higher prevalence of physical events was found (16% vs. 37%, p = 0.07).CONCLUSIONS: In patients with pre-existing anxiety disorders, TS was predominantly triggered by exclusively emotional stressful events, thereby suggesting a possible relationship between anxiety and emotional cardiac frailty in TS patients.

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