Patients with takotsubo cardiomyopathy with concurrent psychiatric disorders showed higher markers of cardiac stress compared with those without mental health conditions, according to recent findings.
The research, conducted by Molly Milano and colleagues, was chosen as a 2025 Arthur E. Weyman Young Investigator’s Award Competition Finalist. Their findings were presented at the American Society of Echocardiography (ASE) 2025 annual meeting and as an abstract in the Journal of the American Society of Echocardiography.
In the retrospective study of 58 patients with takotsubo cardiomyopathy, investigators found that those with psychiatric conditions—including depression, anxiety, and bipolar disorder—had significantly higher left ventricular end-diastolic pressure (LVEDP) (25.5 vs. 19.5 mmHg) and elevated N-terminal pro–brain natriuretic peptide (NT-proBNP) levels (2,511 vs. 1,322 ng/ml) compared with patients without psychiatric disorders. These findings suggest increased myocardial stress and impaired diastolic relaxation in the psychiatric cohort.
Milano and her colleagues from St. Francis Hospital in Roslyn, New York, analyzed 22 patients with psychiatric disorders requiring medical treatment and compared them with 36 patients without psychiatric conditions. All participants met the Mayo Clinic diagnostic criteria for takotsubo cardiomyopathy, a stress-induced heart condition characterized by transient left ventricular dysfunction mimicking acute coronary syndrome.
Notable metabolic disparities were also identified. Diabetes mellitus was significantly more common in psychiatric patients (31.8% vs. 5.6%). Body mass index trended higher in the psychiatric cohort (27.4 vs. 24.9 kg/m²), though this difference did not reach statistical significance. Other clinical and hemodynamic measures—including left ventricular ejection fraction (30% vs. 33%), systolic blood pressure, heart rate, coronary artery disease, and hypertension—did not differ significantly between groups.
The elevated NT-proBNP levels—a biomarker associated with ventricular stress and heart failure—combined with higher LVEDP provide objective evidence of increased cardiovascular burden in takotsubo patients with psychiatric disorders.
However, the authors noted that while these associations are significant, causality cannot be inferred. Further studies are needed to explore the pathophysiological mechanisms linking psychiatric disorders, metabolic comorbidities, and cardiac dysfunction.
Disclosures were not made available at press time.