Evidence map›Paper›PMID 30586731›Full record

Trial reportCirculation2019

Myocardial and Systemic Inflammation in Acute Stress-Induced (Takotsubo) Cardiomyopathy.

Caroline Scally, Hassan Abbas, Trevor Ahearn, Janaki Srinivasan, Alice Mezincescu, Amelia Rudd, Nicholas Spath, Alim Yucel-Finn, Raif Yuecel, Keith Oldroyd and 8 more

3 registry-linked trialsOpen access · bronzeAbstract readClinical TrialComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 160 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
160citing papers in PubMed, 5 pooled it
24.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07065383 narecruitingstarted 2025, after this paper: background citation

Intramyocellular Lipid Compartments After Glucagon-like Peptide 1 Receptor Agonist Therapy in Type 2 Diabetes - Rebalancing the Fat Content of the Heart and Muscles

Ran2025Enrolled60Registered outcomes2Posted comparisons0ConditionsDiabetes Mellitus Type 2ArmsSemaglutide administration plus dietary counselling and physical activity encouragement, Semaglutide plus a personalised and supervised program of resistance and endurance training
PMID 28266779PMID 33567185PMID 37952131PMID 27633186PMID 22547801PMID 9094069PMID 35296869PMID 34675928PMID 3292505PMID 30131397PMID 29203776PMID 27553599other papers from this trial
Open the trial in the graph
NCT02897739 completednot on this map

Pathogenesis of Acute Stress Induced (Tako-tsubo) Cardiomyopathy: Energy Shut-Down or Intense Inflammation? The TERRIFIC Study

Typeobservational_patient_registrySponsorUniversity of AberdeenRan2015 to 2019Enrolled77ConditionsTako-tsubo CardiomyopathyArmsMagnetic resonance imaging, Acute Inflammatory Activation study, PET CT, Psychological assessment
NCT04458883 narecruitingnot on this mapstarted 2020, after this paper: background citation

The Next Leap in Cardiac Magnetic Resonance Imaging:Cycling the Field The TITAN Study

TypeinterventionalSponsorUniversity of AberdeenRan2020 to 2027Enrolled150ConditionsMyocardial InfarctionArmsCardiac Magnetic Resonance Imaging, Fast Field Cycling - Magnetic Resonance Imaging, Electrocardiogram, Echocardiogram
3 · Its place in the literature

Who cites it

160 citing papers in PubMed, 5 syntheses or guidelines pooled it, 282 citations in OpenAlex.

  1. Pooled it
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  4. SCMR Position Paper (2020) on clinical indications for cardiovascular magnetic resonance.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2020
    Guideline
  5. Pooled it
  6. Trial
  7. A novel parameter for risk stratification in patients with takotsubo syndrome.American heart journal plus : cardiology research and practice · 2026
    Article
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  10. Observational
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100 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 3 countries.

Caroline ScallyAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Hassan AbbasAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Trevor AhearnAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Janaki SrinivasanAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Alice MezincescuAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Amelia RuddAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Nicholas SpathBHF Centre for Cardiovascular Sciences, University of Edinburgh, UK (N.S., D.E.N., S.S.).
Alim Yucel-FinnAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Raif YuecelAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Keith OldroydWest of Scotland Regional Heart & Lung Centre, Glasgow, UK (K.O.).
Ciprian DospinescuAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Graham HorganBiomathematics & Statistics Scotland, Aberdeen, UK (G.H.).
Paul BroadhurstAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Anke HenningUniversity of Tubingen, Germany (A.H.).
David E NewbyBHF Centre for Cardiovascular Sciences, University of Edinburgh, UK (N.S., D.E.N., S.S.).
Scott SempleBHF Centre for Cardiovascular Sciences, University of Edinburgh, UK (N.S., D.E.N., S.S.).
Heather M WilsonAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Dana K DawsonAberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
University of Aberdeen · GBUniversity of Edinburgh · GBBiomathematics and Statistics Scotland · GBLung Institute · USUniversity of Tübingen · DE

Funding

British Heart Foundation CH/09/002British Heart Foundation CH/09/002/26360British Heart Foundation FS/17/19/32641British Heart Foundation PG/15/108/31928British Heart Foundation RE/13/3/30183Wellcome TrustWellcome Trust WT103782AIA
6 · The paper itself

Abstract

backgroundAcute stress-induced (takotsubo) cardiomyopathy can result in a heart failure phenotype with a prognosis comparable with that of myocardial infarction. In this study, we hypothesized that inflammation is central to the pathophysiology and natural history of takotsubo cardiomyopathy.

methodsIn a multicenter study, we prospectively recruited 55 patients with takotsubo cardiomyopathy and 51 age-, sex-, and comorbidity-matched control subjects. During the index event and at the 5-month follow-up, patients with takotsubo cardiomyopathy underwent multiparametric cardiac magnetic resonance imaging, including ultrasmall superparamagnetic particles of iron oxide (USPIO) enhancement for detection of inflammatory macrophages in the myocardium. Blood monocyte subpopulations and serum cytokines were assessed as measures of systemic inflammation. Matched control subjects underwent investigation at a single time point.

resultsSubjects were predominantly middle-aged (64±14 years) women (90%). Compared with control subjects, patients with takotsubo cardiomyopathy had greater USPIO enhancement (expressed as the difference between pre-USPIO and post-USPIO T2*) in both ballooning (14.3±0.6 milliseconds versus 10.5±0.9 milliseconds; P<0.001) and nonballooning (12.9±0.6 milliseconds versus 10.5±0.9 milliseconds; P=0.02) left ventricular myocardial segments. Serum interleukin-6 (23.1±4.5 pg/mL versus 6.5±5.8 pg/mL; P<0.001) and chemokine (C-X-C motif) ligand 1 (1903±168 pg/mL versus 1272±177 pg/mL; P=0.01) concentrations and classic CD14

conclusionsWe demonstrate for the first time that takotsubo cardiomyopathy is characterized by a myocardial macrophage inflammatory infiltrate, changes in the distribution of monocyte subsets, and an increase in systemic proinflammatory cytokines. Many of these changes persisted for at least 5 months, suggesting a low-grade chronic inflammatory state. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov . Unique identifier: NCT02897739.

Indexed as

Magnetic Resonance ImagingMyocarditisTakotsubo CardiomyopathyAcute DiseaseAgedChemokine CXCL1FemaleFollow-Up StudiesHumansInflammationInterleukin-6MaleMiddle AgedProspective StudiesChemokine CXCL1CXCL1 protein, humanIL6 protein, humanInterleukin-6cardiomyopathiescytokinesinflammationmacrophagesmonocytestakotsubo cardiomyopathyultrasmall superparamagnetic iron oxide particles (USPIO)

Identifiers

PMID30586731
PMCPMC6438459
OpenAlexW2900479021

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.