Takotsubo syndrome, also known as “broken heart syndrome,” is a sudden cardiac condition that primarily affects postmenopausal women and can be triggered by acute emotional or physical stress.
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The syndrome accounts for about 2% of cases initially believed to be heart attacks and affects as many as one in 10 women with acute coronary syndrome, according to a report published by ScienceDaily.
Despite this, distinguishing Takotsubo syndrome from a true heart attack can be particularly difficult during the early stages of medical assessment.
Patients with Takotsubo syndrome may experience sudden chest pain, abnormal electrocardiogram results, and elevated levels of cardiac enzymes, all of which closely resemble the signs of a heart attack.
The key difference, however, is that Takotsubo syndrome does not involve blocked coronary arteries. Because the two conditions initially appear almost identical, many patients undergo invasive cardiac catheterization before doctors can determine the actual cause of their symptoms.
An international research team, working closely with scientists from the University of Zurich and the University of Greifswald, has developed a new diagnostic scoring system aimed at identifying Takotsubo syndrome before cardiac catheterization. Known as the BioTAK score, the new system combines biological sex with several blood biomarkers associated with different processes in the cardiovascular system.
The researchers used artificial intelligence to determine which combination of these biomarkers provided the most accurate diagnostic information, then incorporated them into a clinical decision tool.
In an independent validation group of about 1,800 additional patients, the score identified Takotsubo syndrome with high accuracy, correctly classifying about 90% of participants using predefined thresholds before they underwent cardiac catheterization.
Florian Wenzel, first co-author of the study from the Center for Molecular Cardiology at the University of Zurich and the Department of Medicine at the University of Oxford, said: “Our study shows that a simple combination of blood biomarkers and biological sex can identify these patients with remarkable accuracy, even before cardiac catheterization.”
Victor Schweiger, first co-author from University Hospital Zurich, added: “At the same time, these biomarkers provide insights into the biological processes that distinguish Takotsubo syndrome from a conventional heart attack.”
Beyond its potential diagnostic value, the BioTAK score also provides new insights into the biology of the syndrome. Two newly identified biomarkers incorporated into the system point to an important role for what is known as the brain-heart axis, suggesting that the condition develops through mechanisms that are entirely distinct from atherosclerosis.
One of these proteins helps activate a group of neuropeptides associated with the stress and anxiety response, vascular tension and autonomic nervous system activity. The other protein is linked to the stability of atherosclerotic plaques in the arteries. When combined, the two biomarkers reveal a biological pattern that differs fundamentally from what is typically seen in a conventional heart attack.
Thomas Lüscher, the study’s final co-author from the National Heart and Lung Institute at Imperial College London, explained: “By tracking signaling pathways associated with the stress response, cardiac dysfunction and plaque stability, the BioTAK score translates complex disease mechanisms into a practical diagnostic tool.”
The researchers noted that the score could become a useful addition to early emergency-room assessment of patients suspected of having acute coronary syndrome.
Christian Templin, the study’s final co-author, head of the Department of Internal Medicine at University Medical Center Greifswald and founder of the international InterTAK Registry, said: “The BioTAK score is not a substitute for cardiac catheterization when it is medically necessary. However, it may help guide diagnostic procedures more effectively and avoid unnecessary invasive testing in a selected group of patients. Our goal is to identify patients with Takotsubo syndrome earlier and more reliably in the future, while gaining a deeper understanding of the underlying disease mechanisms.”
Future research will examine whether incorporating the score into routine clinical care can improve the diagnosis and treatment of Takotsubo syndrome.
Source: Alarabiya
