Characterization of Sympathetic Nerve Activity in Stress Cardiomyopathy

Stress (Takotsubo) cardiomyopathy (SC) is a peculiar form of acute, reversible myocardial
dysfunction predominantly affecting the apical and mid left ventricular segments. This was
originally described in Japan but is increasingly recognized all over the world especially
in older women. There is evidence to support that excess sympathetic activation and
catecholamine surges are potential mechanisms that cause this temporary myocardial
'stunning'. The amount of catecholamines in circulation of patients with SC was 2 to 3-fold
higher when compared to subjects with acute myocardial infarction related equivalent cardiac
dysfunction [Wittstein, et al. NEJM, 2005].

In this institution over the last two to three years the investigators have identified more
than a dozen patients with stress cardiomyopathy. This diagnosis has been confirmed by
echocardiographic documentation of normalization of left ventricular function over a course
of few days to weeks. The investigators' overarching goal is to further characterize these
individuals with the hope of identifying risk factors and developing strategies to prevent
the occurrence of SC in situations where the likelihood in susceptible individuals may be
high.

Inclusion Criteria:

- Diagnosis of stress cardiomyopathy in the past

Exclusion Criteria:

- Coronary artery disease (CAD), primary coronary intervention (PCI) or coronary artery
bypass graft (CABG)

- Cardiac dysfunction

- Heart failure

- Significant arrhythmias

- Severe chronic obstructive pulmonary disease (COPD)

- Diabetic neuropathy

- Pregnancy