What is it about?

Results of a recent study might shed new light on a previously poorly understood disease. Takotsubo cardiomyopathy, also referred to as stress cardiomyopathy or broken heart syndrome, is a rare but life-threatening heart disease ensuing from extreme stress situations. A strong relationship to thyroid diseases has been suggested, but it has never been proved since the available evidence was based on case reports and small series only. A multicentre study in interdisciplinary research cooperation by cardiologists and endocrinologists in Bochum and Mannheim, Germany, has now systematically evaluated the thyroid function in a group of patients with takotsubo syndrome. Hormone concentrations were compared with healthy controls and with subjects suffering from myocardial infarction. Supported by artificial intelligence and methods of systems biology the researchers found a strong relationship between thyroid homeostasis and takotsubo syndrome. This relationship occurred in two sub-forms, one of them (“endocrine type”) being mediated by thyrotoxicosis and the other one (“stress type”) by an increased set point of thyroid function, probably directly resulting from the stressor.

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Why is it important?

It was previously unclear why stress events affect the heart in a very different extent. The results of the new study deliver a novel explanatory model that traces an increased myocardial sensitivity for stress hormones back to sensitisation by thyroid hormones.


The results of the study underscore the importance of psychoendocrine interactions in severe illness. Thyroid function may serve as a future biomarker for the individual evolution of takotsubo syndrome, and it may help for personalised optimisation of drug therapy.

PD Dr. med. Johannes W Dietrich
Ruhr-Universitat Bochum

Read the Original

This page is a summary of: Abnormal thyroid function is common in takotsubo syndrome and depends on two distinct mechanisms: results of a multicentre observational study, Journal of Internal Medicine, November 2020, Wiley,
DOI: 10.1111/joim.13189.
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