WJCD  Vol.5 No.12 , December 2015
Extent of Myocardial Damage in Patients after Emotional Stress-Induced Myocardial Infarction during Euro Cup Soccer 2008
ABSTRACT
Background: The World Cup soccer 2006 has been shown to provoke levels of stress sufficient to increase the incidence of acute coronary syndrome. However, the clinical outcome of these patients remains elusive. We sought to assess whether emotional stress-induced myocardial infarction might increase myocardial damage compared to non-stress-induced events. Design and Methods: We prospectively analysed the extent of left ventricular damage after emotional stress-induced myocardial infarction occurred during Euro Cup Soccer 2008 (study group, n = 51). Data were compared to a matched reference group (n = 55). The primary endpoint was a composite of cardiac troponin-T/I and the left ventricular ejection fraction at day 4th after the initial event. Results: Compared to standard values of troponin T and troponin I, concentrations were increased in both the study group and the reference group (troponin T: 4.7 ± 8.5 ng/ml vs. 2.4 ± 4.3 ng/ml; troponin I: 13.1 ± 16.5 ng/ml vs. 8.7 ± 13.9 ng/ml). The difference, adjusted for confounding variables, between both groups did not reach statistical significance (p = 0.33). Likewise, left ventricular ejection fraction (EF) was decreased in both the study patients and the reference group (51% ± 12% EF vs. 55% ± 10% EF), the difference between both groups was just not significant (p = 0.12). Discussion: In conclusion, because of the lack of significance, we cannot testify at present, weather emotional stress, e.g. induced by soccer matches of the national team, influences the extent of myocardial damage following myocardial infarction. However, a positive correlation can be assumed, because the troponin levels are considerably higher in the study group than in the control group.

Cite this paper
Eigenwillig, A. , Lackermair, K. , Deffner, V. , Küchenhoff, H. , Nickel, T. and Wilbert-Lampen, U. (2015) Extent of Myocardial Damage in Patients after Emotional Stress-Induced Myocardial Infarction during Euro Cup Soccer 2008. World Journal of Cardiovascular Diseases, 5, 388-396. doi: 10.4236/wjcd.2015.512044.
References
[1]   Leor, J., Poole, W.K. and Kloner, R.A. (1996) Sudden Cardiac Death Triggered by an Earthquake. The New England Journal of Medicine, 334, 413-419.
http://dx.doi.org/10.1056/nejm199602153340701

[2]   Tofler, G.H. and Muller, J.E. (2006) Triggering of Acute Cardiovascular Disease and Potential Preventive Strategies. Circulation, 114, 1863-1872.

[3]   Wilbert-Lampen, U. (2009) Experimentelle und epidemiologische Untersuchungen zu Stress-vermittelten kardiovaskul?ren Erkrankungen: Von der Endothel-und Monozytendysfunktion zu akuten kardialen Ereignissen.

[4]   Wilbert-Lampen, U., Nickel, T., Leistner, D., Guthlin, D., Matis, T., Volker, C., et al. (2010) Modified Serum Profiles of Inflammatory and Vasoconstrictive Factors in Patients with Emotional Stress-Induced Acute Coronary Syndrome during World Cup Soccer 2006. Journal of the American College of Cardiology, 55, 637-642.

[5]   Berthier, F. and Boulay, F. (2003) Lower Myocardial Infarction Mortality in French Men the Day France Won the 1998 World Cup of Football. Heart, 89, 555-556.
http://dx.doi.org/10.1136/heart.89.5.555

[6]   Brunekreef, B. and Hoek, G. (2002) No Association between Major Football Games and Cardiovascular Mortality. Epidemiology, 13, 491-492.
http://dx.doi.org/10.1097/00001648-200207000-00022

[7]   Kandzari, D.E., Tcheng, J.E., Grines, C.L., Cox, D.A., Stuckey, T., Griffin, J.J., et al. (2004) Influence of Admission and Discharge Aspirin Use on Survival after Primary Coronary Angioplasty for Acute Myocardial Infarction. The American Journal of Cardiology, 94, 1029-1033.

[8]   Kirkup, W. and Merrick, D.W. (2003) A Matter of Life and Death: Population Mortality and Football Results. Journal of Epidemiology and Community Health, 57, 429-432.
http://dx.doi.org/10.1136/jech.57.6.429

[9]   Toubiana, L., Hanslik, T. and Letrilliart, L. (2001) French Cardiovascular Mortality Did Not Increase during 1996 European Football Championship. BMJ, 322, 1306.

[10]   Witte, D.R., Bots, M.L., Hoes, A.W. and Grobbee, D.E. (2000) Cardiovascular Mortality in Dutch Men during 1996 European Football Championship: Longitudinal Population Study. BMJ, 321, 1552-1554.

[11]   Wilbert-Lampen, U., Leistner, D., Greven, S., Pohl, T., Sper, S., Volker, C., et al. (2008) Cardiovascular Events during World Cup Soccer. The New England Journal of Medicine, 358, 475-483.
http://dx.doi.org/10.1056/NEJMoa0707427

[12]   Mercanoglu, G., Safran, N., Uzun, H. and Eroglu, L. (2008) Chronic Emotional Stress Exposure Increases Infarct Size in Rats: The Role of Oxidative and Nitrosative Damage in Response to Sympathetic Hyperactivity. Methods and Findings in Experimental and Clinical Pharmacology, 30, 745-752.
http://dx.doi.org/10.1358/mf.2008.30.10.1316822

[13]   Bellenger, N.G., Burgess, M.I., Ray, S.G., Lahiri, A., Coats, A.J., Cleland, J.G., et al. (2000) Comparison of Left Ventricular Ejection Fraction and Volumes in Heart Failure by Echocardiography, Radionuclide Ventriculography and Cardiovascular Magnetic Resonance; Are They Interchangeable? European Heart Journal, 21, 1387-1396.

[14]   Chi, J.S. and Kloner, R.A. (2003) Stress and Myocardial Infarction. Heart, 89, 475-476.

[15]   Gibbons, R.J., Valeti, U.S., Araoz, P.A. and Jaffe, A.S. (2004) The Quantification of Infarct Size. Journal of the American College of Cardiology, 44, 1533-1542.
http://dx.doi.org/10.1016/j.jacc.2004.06.071

[16]   Burns, R.J., Gibbons, R.J., Yi, Q., Roberts, R.S., Miller, T.D., Schaer, G.L., et al. (2002) The Relationships of Left Ventricular Ejection Fraction, End-Systolic Volume Index and Infarct Size to Six-Month Mortality after Hospital Discharge Following Myocardial Infarction Treated by Thrombolysis. Journal of the American College of Cardiology, 39, 30-36.
http://dx.doi.org/10.1016/S0735-1097(01)01711-9

[17]   Popovic, A.D., Neskovic, A.N., Babic, R., Obradovic, V., Bozinovic, L., Marinkovic, J., et al. (1994) Independent Impact of Thrombolytic Therapy and Vessel Patency on Left Ventricular Dilation after Myocardial Infarction. Serial Echocardiographic Follow-Up. Circulation, 90, 800-807.

[18]   Holman, E.R., Buller, V.G., de Roos, A., van der Geest, R.J., Baur, L.H., van der Laarse, A., et al. (1997) Detection and Quantification of Dysfunctional Myocardium by Magnetic Resonance Imaging. A New Three-Dimensional Method for Quantitative Wall-Thickening Analysis. Circulation, 95, 924-931.

[19]   Katus, H.A., Remppis, A., Neumann, F.J., Scheffold, T., Diederich, K.W., Vinar, G., et al. (1991) Diagnostic Efficiency of Troponin T Measurements in Acute Myocardial Infarction. Circulation, 83, 902-912.
http://dx.doi.org/10.1161/01.CIR.83.3.902

[20]   Remppis, A., Ehlermann, P., Giannitsis, E., Greten, T., Most, P., Muller-Bardorff, M., et al. (2000) Cardiac Troponin T Levels at 96 Hours Reflect Myocardial Infarct Size: A Pathoanatomical Study. Cardiology, 93, 249-253.
http://dx.doi.org/10.1159/000007034

[21]   Steen, H., Giannitsis, E., Futterer, S., Merten, C., Juenger, C. and Katus, H.A. (2006) Cardiac Troponin T at 96 Hours after Acute Myocardial Infarction Correlates with Infarct Size and Cardiac Function. Journal of the American College of Cardiology, 48, 2192-2194.
http://dx.doi.org/10.1016/j.jacc.2006.06.002

[22]   Hallen, J. (2012) Troponin for the Estimation of Infarct Size: What Have We Learned? Cardiology, 121, 204-212.
http://dx.doi.org/10.1159/000337113

[23]   Chia, S., Senatore, F., Raffel, O.C., Lee, H., Wackers, F.J. and Jang, I.K. (2008) Utility of Cardiac Biomarkers in Predicting Infarct Size, Left Ventricular Function, and Clinical Outcome after Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction. JACC Cardiovascular Interventions, 1, 415-423.
http://dx.doi.org/10.1016/j.jcin.2008.04.010

[24]   Gallegos, R.P., Swingen, C., Xu, X.J., Wang, X., Bianco, R., Jerosch-Herold, M., et al. (2004) Infarct Extent by MRI Correlates with Peak Serum Troponin Level in the Canine Model. The Journal of Surgical Research, 120, 266-271.
http://dx.doi.org/10.1016/j.jss.2004.02.025

[25]   Katus, H.A., Frey, N. and Muller-Bardorff, M. (1998) Cardiac Troponins in Patients with Chest Pain. The New England Journal of Medicine, 338, 1314-1315.

[26]   Keller, T., Zeller, T., Peetz, D., Tzikas, S., Roth, A., Czyz, E., et al. (2009) Sensitive Troponin I Assay in Early Diagnosis of Acute Myocardial Infarction. The New England Journal of Medicine, 361, 868-877.
http://dx.doi.org/10.1056/NEJMoa0903515

[27]   Schiller, N.B., Shah, P.M., Crawford, M., DeMaria, A., Devereux, R., Feigenbaum, H., et al. (1989) Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. Journal of the American Society of Echocardiography, 2, 358-367.

[28]   Apple, F.S., Sharkey, S.W., Falahati, A., Murakami, M., Mitha, N. and Christensen, D. (1998) Assessment of Left Ventricular Function Using Serum Cardiac Troponin I Measurements Following Myocardial Infarction. Clinica Chimica Acta, 272, 59-67.
http://dx.doi.org/10.1016/S0009-8981(97)00252-0

[29]   Wilbert-Lampen, U., Nickel, T., Scheipl, F., Greven, S., Kuchenhoff, H., Kaab, S., et al. (2011) Mortality Due to Myocardial Infarction in the Bavarian Population during World Cup Soccer 2006. Clinical Research in Cardiology, 100, 731-736.
http://dx.doi.org/10.1007/s00392-011-0302-7

 
 
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