Estrogen supplementation attenuated stress-induced cardiac changes and central sympathetic outflow in rats, suggesting reduced estrogen post-menopause contributes to takotsubo cardiomyopathy.
Does estrogen supplementation or adrenoceptor blockade prevent cardiac and neural changes in a rat model of stress-induced takotsubo cardiomyopathy?
Estrogen deficiency may contribute to the pathogenesis of takotsubo cardiomyopathy by exacerbating stress-induced hypothalamo-sympathoadrenal outflow, suggesting a protective role for estrogen.
Emotional stress triggers takotsubo cardiomyopathy in postmenopausal women. Clinical analysis of autonomic nervous function has revealed a transient increase of sympathetic nervous activity and decrease of vagal nervous activity. Immobilization (IMO) stress of rats can reproduce the electrocardiographic and left ventriculographic changes that occur in takotsubo cardiomyopathy, both of which are prevented by combined blockade of alpha- and beta-adrenoceptors. Estrogen supplementation partially attenuated these cardiac changes. It also attenuated the IMO-induced increase of c-Fos immunoreactivity, or c-fos mRNA expression in the lateral septum, medial amygdaloid nucleus, paraventricular hypothalamic nucleus, dorsomedial hypothalamic nucleus, laterodorsal tegmental nucleus, and locus ceruleus; these regions contain central sympathetic neurons and neurons with immunoreactive estrogen receptors. It also downregulated c-fos mRNA expression in the adrenal gland and the heart, suggesting an increase of estrogen attenuated the stress-induced hypothalamo-sympathoadrenal outflow from the central nervous system to the target organs. Estrogen treatment also upregulated the levels of cardioprotective substances, such as atrial natriuretic peptide and heat shock protein 70, in the heart. These data suggest that reduction of estrogen levels following menopause might be involved in the primary cause of takotsubo cardiomyopathy both by indirect action on the nervous system and by direct action on the heart.
Ueyama et al. (Mon,) conducted a review in Takotsubo cardiomyopathy. Estrogen supplementation was evaluated. Estrogen supplementation attenuated stress-induced cardiac changes and central sympathetic outflow in rats, suggesting reduced estrogen post-menopause contributes to takotsubo cardiomyopathy.