Does the personality trait of neuroticism cause vulnerability for Takotsubo cardiomyopathy? A literature review.

Introduction: Takotsubo cardiomyopathy (TTC) is a transient left ventricular apical, medial or basal dysfunction, recovering completely without myocardial injury. It was first clinically described in 1991 by Sato et al. Impact of psychological distress and personality factors remains unclear. The aim of the study was to assess if the personality trait of neuroticism, can increase the vulnerability for TTC. Material and methods: A systematic literature search was performed in MEDLINE in august 2018, using relevant MeSH terms obtained from PubMed. The search was limited to literature in the time period 2007 – 2018. Study designs included clinical studies, comparative studies, interviews, journal articles, randomized control trials, “reviews” and systematic reviews. 206 records were identified through database searching. After screening of abstracts, 88 articles remained. Selected studies were then assessed for their relevance to the thesis and for scientific quality. Results: TTC consists predominantly of postmenopausal women. Presenting symptoms are chest pain and dyspnea. The majority has an emotional stressor combined with a physical or isolated emotional stressor. Anxiety and distress are observed as prominent factors. Though, a correlation between personality type D (PTD) or neuroticism with TTC is incomplete regarding evidence. Most studies underline acute stressful events as a trigger for TTC, while other publications highlight the impact of cumulative stress as more significant. Conclusion: The current literature did not show significant correlations between TTC, depression, PTD and neuroticism. However, anxiety has been proven to be a prominent feature. Studies have identified stressful events immediately preceding the acute event. However, some results indicate that exposure to repeated stressful events may have a more decisive role in onset of TTC. Response to distressing factors depends on personality traits, vulnerability and resilience. Nevertheless, more research is needed regarding correlation between neuroticism and TTC

The basis of analgesic activity of four Chinese herbs.

his study investigate the effects of four Chinese herbs for their potential therapeutic use as analgesics. It involved screening for inhibitors of enkephalin-hydrolysing enzymes, especially selective NEP inhibitors, mixed NEP/APN inhibitors and mixed NEP/ACE inhibitors. NEP was the key enzyme in the screening systems. Four Chinese herbs Yan (Corydalis yanhusuo 7: Wang); Gou (Nauclea siý7ensis Oliv. ); Qiang (Notopterygium incisum Ting ex H. T (7hang); and Chuan (Ligusticum chuanxiong Hort. ) were tested for their inhibitory effects on NEP activity measured in a rat kidney extract. Aqueous extracts of Gou and Qiang showed the significant inhibitory activity on NEP but results with organic extracts were not significant. Gou showed the strongest inhibitory activity on NEP. It was found that Gou also showed an inhibitory activity on the other two enkephalin-hydrolysing enzymes, APN and ACE in the microsomal mixture. A rat-brain opiate-receptor preparation (section 5.2.1) was used in ligand binding experiments with competition for the receptor sites between the aqueous Gou extract and tritium-labelled naloxone. For very small quantities of Gou there was a lowering of naloxone binding showing the antagonistical action of Gou. At higher concentrations (> 4 mg/ml of Gou) there was a tendency for naloxone binding to increase demonstrating potential agonistic activity. To test whether one compound in Gou had inhibitory activity on the three enzymes, or several compounds acting together, the aqueous extract of Gou was separated by HPLC. The HPLC-eluted fractions were pooled into seven parts and collected. The seven eluates were assayed for their effects on NEP proteolysis of 3H(leu)- enkephalin. Only six eluates showed inhibitory activity on NEP. The three single compounds already fractionated by others (rhynchophylline, mitraphylline and poteropodine) were shown to correspond in the Pool 7. An unexpectedly large number of active fractions suggest that many active compounds are present in Gou. It can be concluded that of the four herbs tested Gou (Nauclea sinensis Oliv) offers considerable potential as a novel analgesic agent.The work described in this dissertation was carried out in the School of Biomolecular Science, Liverpool John Moores University from October 1994 to May 1999. Unless otherwise stated it is the original work of the author. This dissertation has not been submitted, in whole or in part, for any other degree at this or any other university

Medicīnas sekcija (2017.gada 24.februārī): tēžu krājums

Supported by: Faculty of Medicine, University of Latvia, Latvijas Inovatīvās medicīnas fonds, Latvijas Invazīvās kardioloģijas attīstības biedrība, AS “Sistēmu Inovācijas”, Doktorantūras skola “Translācijas izpētē medicīnā