A Prospective Pilot Study to Identify a Myocarditis Cohort who may Safely Resume Sports Activities 3 Months after Diagnosis

International cardiovascular society recommendations to return to sports activities following acute myocarditis are based on expert consensus in the absence of prospective studies. We prospectively enrolled 30 patients with newly diagnosed myocarditis based on clinical parameters, laboratory measurements and cardiac magnetic resonance imaging with mildly reduced or pre served left ventricular ejection fraction (LVEF) with a follow-up of 12 months. Cessation of physical activity was recommended for 3 months. The average age was 35 (19–80) years with 73% male patients. One case of non-sustained ventricular tachycardia was recorded during 48-h-Holter electrocardiogram. Except for this case, all patients were allowed to resume physical exercise after 3 months. At 6- (n = 26) and 12-month (n = 19) follow-up neither cardiac events nor worsening LVEF were recorded. The risk of cardiac events at 1 year after diagnosis of myocarditis appears to be low after resumption of exercise after 3 months among patients who recover from acute myocarditis

Happy heart syndrome. role of positive emotional stress in takotsubo syndrome

AIMS: Takotsubo syndrome (TTS) is typically provoked by negative stressors such as grief, anger, or fear leading to the popular term 'broken heart syndrome'. However, the role of positive emotions triggering TTS remains unclear. The aim of the present study was to analyse the prevalence and characteristics of patients with TTS following pleasant events, which are distinct from the stressful or undesirable episodes commonly triggering TTS. METHODS AND RESULTS: Takotsubo syndrome patients with preceding pleasant events were compared to those with negative emotional triggers from the International Takotsubo Registry. Of 1750 TTS patients, we identified a total of 485 with a definite emotional trigger. Of these, 4.1% (n = 20) presented with pleasant preceding events and 95.9% (n = 465) with unequivocal negative emotional events associated with TTS. Interestingly, clinical presentation of patients with 'happy heart syndrome' was similar to those with the 'broken heart syndrome' including symptoms such as chest pain [89.5% (17/19) vs. 90.2% (412/457), P = 1.0]. Similarly, electrocardiographic parameters, laboratory findings, and 1-year outcome did not differ. However, in a post hoc analysis, a disproportionate higher prevalence of midventricular involvement was noted in 'happy hearts' compared with 'broken hearts' (35.0 vs. 16.3%, P = 0.030). CONCLUSION: Our data illustrate that TTS can be triggered by not only negative but also positive life events. While patient characteristics were similar between groups, the midventricular TTS type was more prevalent among the 'happy hearts' than among the 'broken hearts'. Presumably, despite their distinct nature, happy and sad life events may share similar final common emotional pathways, which can ultimately trigger TTS

Clinical correlates and prognostic impact of neurologic disorders in Takotsubo syndrome

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Cardiac alterations are frequently observed after acute neurological disorders. Takotsubo syndrome (TTS) represents an acute heart failure syndrome and is increasingly recognized as part of the spectrum of cardiac complications observed after neurological disorders. A systematic investigation of TTS patients with neurological disorders has not been conducted yet. The aim of the study was to expand insights regarding neurological disease entities triggering TTS and to investigate the clinical profile and outcomes of TTS patients after primary neurological disorders. The International Takotsubo Registry is an observational multicenter collaborative effort of 45 centers in 14 countries (ClinicalTrials.gov, identifier NCT01947621). All patients in the registry fulfilled International Takotsubo Diagnostic Criteria. For the present study, patients were included if complete information on acute neurological disorders were available. 2402 patients in whom complete information on acute neurological status were available were analyzed. In 161 patients (6.7%) an acute neurological disorder was identified as the preceding triggering factor. The most common neurological disorders were seizures, intracranial hemorrhage, and ischemic stroke. Time from neurological symptoms to TTS diagnosis was ≤ 2 days in 87.3% of cases. TTS patients with neurological disorders were younger, had a lower female predominance, fewer cardiac symptoms, lower left ventricular ejection fraction, and higher levels of cardiac biomarkers. TTS patients with neurological disorders had a 3.2-fold increased odds of in-hospital mortality compared to TTS patients without neurological disorders. In this large-scale study, 1 out of 15 TTS patients had an acute neurological condition as the underlying triggering factor. Our data emphasize that a wide spectrum of neurological diseases ranging from benign to life-threatening encompass TTS. The high rates of adverse events highlight the need for clinical awareness.The International Takotsubo Registry was supported by the Biss Davies Charitable Trust. Dr. Scheitz has been supported by the Corona Foundation. Dr. Templin has been supported by the H.H. Sheikh Khalifa bin Hamad Al-Thani Research Programme and the Swiss Heart Foundation.info:eu-repo/semantics/publishedVersio

The impact of exposure to violence on internalizing symptomatology and adolescent suicidal ideation

Few studies have examined the effects of exposure to community violence on suicidal ideation and related mental health outcomes, including depression and hopelessness. This study examined the effects of exposure to violence on 170 adolescents\u27 self-reported levels of suicidal ideation, depression, and hopelessness. In addition, the study examined the impact of specific theoretical components of violence (i.e., violence towards an unfamiliar person, violence towards a friend or family member, violence towards yourself, violence towards society) and depression (i.e., dysphoric mood, anhedonia, negative self-statements, somatic complaints) on participants\u27 suicidal ideation. Overall, 83.3% of the participants had been exposed to some form of community violence, 43% of the participants were at significant suicidal risk, 26% of the participants were at significant risk for depression, and 19% of the participants reported moderate to severe levels of hopelessness. Significant gender differences were found, with females reporting higher levels of suicidal ideation, depression, and hopelessness than males. Elevated levels of exposure to community violence were noted to significantly increase the odds of female participants being at-risk for suicidal ideation and hopelessness. However, exposure to community violence was not found to have an effect on the mental health outcomes of male participants. In addition, Caucasian participants were found to report significantly higher levels of suicidal ideation and hopelessness than African American participants. Violence experienced by the participants and violence directed at society were noted to increase the odds of male and female participants\u27 levels of suicidal ideation, respectively. Additionally, anhedonia and negative self-statements increased the participants\u27 odds of being at-risk for suicidal ideation above and beyond that accounted for by the other theoretical components of depression. Future research should design more effective assessment protocols that incorporate known risk factors to improve the accuracy and, subsequently, the feasibility of implementing large-scale suicide screening programs into school settings

Admittance measurements on a-Si/c-Si heterojunction solar cells

Hydrogenated amorphous silicon/ crystalline silicon (a- Si: H/ c- Si) solar cells with areas of 1 x 1 cm are produced by deposition of a- Si: H and indium- tin- oxide (ITO) on 3- in. wafers. Three types of samples have been prepared for admittance measurements, differing in the way how the effective area is defined. The measurement geometry is either defined by cutting, by etching the ITO layer outside the 1 cm(2) active area, or by etching the ITO and the a- Si: H outside the active area. Admittance measurements reveal that the lateral conductivity of the ITO is high enough up to a frequency of 1 MHz to ensure a lateral equipotential surface. A simple equivalent network consisting of a parallel resistor- capacitor branch in series to a second resistor controls the cut sample. For the sample with just ITO layer etching, the effects of a lateral channel due to the a- Si: H layer have to be included. The finite dimensions of the sample modify the low- pass character of the channel. The sample with ITO and a- Si: H layer etching delivers the best measurement conditions. In all three cases the dispersion allows the surface doping level of the substrate to be extracted from the CV characteristics measured at 1 MH