心碎综合征

当一个人感到伤心时，通常会说"我的心都碎了"。虽然这只是一种比喻，人的心脏并不会因为悲伤的情绪碎裂成片，但是却可能出现“心碎综合征”。

心碎综合征是指人在经历重大外部事件打击时，会产生极其哀伤、悲痛或愤怒的心理，同时出现了类似于心脏疾病的症状，比如会有胸痛、憋气、呼吸急促等症状表现。

The syndrome, formally known as takotsubo cardiomyopathy, is characterized by weakening of the heart's main pumping chamber and was first identified in 1990 in Japan. It looks and sounds like a heart attack and is consequently often confused for one.

心碎综合征学名为takotsubo心肌病，最早于1990年在日本被发现，其特征是心脏的主泵区功能减弱。症状与心脏病相似，因此经常被混淆。

Affecting an estimated 2,500 people in the UK each year, the syndrome also carries a risk of complications similar to that of an actual heart attack. It is unclear what causes takotsubo, but sharp spikes in adrenaline caused by acute stress like bereavement, car accidents, earthquakes and even happy events such as weddings are understood to drive loss of movement in part of the heart wall, which then precipitates the acute heart failure.

据估算，英国每年有2500人患上心碎综合征，这种综合征还可能引发与心脏病并发症类似的病症。目前尚不清楚是什么导致了心碎综合征，但据了解，丧亲之痛、车祸、地震甚至婚礼等喜事急性应激引起的肾上腺素急剧飙升，会导致部分心壁运动丧失，进而诱发急性心衰。

近日，英国《卫报》报道称，研究发现两种与高应激水平相关的分子与心碎综合征的发生有关。

Two molecules – called microRNA-16 and microRNA-26a — that are linked to depression, anxiety and increased stress levels had previously been detected in the blood of takotsubo patients. Researchers assessed the impact of exposing cells from human hearts (taken from organs that were unsuitable for transplants) and rat hearts to the two molecules.

此前在心碎综合征患者的血液中检测到两种名为微小核糖核酸-16和微小核糖核酸-26a的分子，这两种分子与抑郁、焦虑和压力水平升高有关。研究人员评估了将人类心脏（取自不适合移植的器官）和大鼠心脏的细胞暴露于这两种分子的影响。

Afterwards, both sets of heart cells were more sensitive to adrenaline, they wrote in the journal Cardiovascular Research.

他们在《心血管研究》杂志发表的文章中称，随后发现，这两组心脏细胞对肾上腺素更敏感。

In patients with takotsubo, the bottom of the heart stops beating, and the top of the heart beats more, said the lead study author, Dr Liam Couch from Imperial College London. "Basically, we found the exact same thing happens when we increase the exposure to the molecules [in an experimental setting]. It reproduced exactly what happens in takotsubo, so it made it more likely for the takotsubo to occur."

该研究的主要作者、伦敦帝国理工学院的利亚姆·考奇博士称，心碎综合征患者的心脏底部停止跳动，顶部跳动更多。“基本上，我们发现（在实验环境中）当我们增加心脏对这两种分子的暴露时，会发生完全相同的情况。它准确地再现了心碎综合征发生的情况，因此使心碎综合征发生的可能性更大。”

Overall, the findings appeared to link long-term stress and the dramatic takotsubo response to a sudden shock.

总的来说，研究结果似乎显示了长期的压力与因意外打击引发的突发性心碎综合征之间的关联。

However, the problem is that it is not possible, for now, to diagnose takotsubo in patients before it happens, making it difficult to test whether these molecules are elevated in real-life cases, Couch explained.

然而，考奇解释称，问题是，目前还不能在心碎综合征发生之前对患者进行诊断，这使得在现实中很难检测这些分子是否升高。

"But if we know someone's had takotsubo, theoretically we can measure these molecules, and then predict if they're likely to have it again, because there's a one in five chance that they could have it again," he said.

他说：“但如果我们知道有人患上心碎综合征，理论上我们可以检测这些分子，然后预测他们是否可能再次发病，因为他们有五分之一的可能再次发病。”

Joel Rose, chief executive of the charity Cardiomyopathy UK, said the study provided important insights on a less well known and poorly understood form of cardiomyopathy. "It has the potential to improve our understanding of who may be more susceptible to developing the condition and subsequent improve our ability to manage its impact," he said.

慈善机构“英国心肌病（Cardiomyopathy UK）”首席执行官乔尔·罗斯称，这项研究对一种鲜为人知、缺乏了解的心肌病提供了重要见解，有可能提高我们对这种疾病易见于哪些人群的认识，进而增强我们控制其影响的能力。”

Further research is needed, said Prof Metin Avkiran, the associate medical director at the British Heart Foundation, to “determine if drugs that block these microRNAs could be the key to avoiding broken hearts”.

英国心脏基金会医学副主任梅廷•阿夫基兰教授表示，还需要进一步的研究，以“确定阻断这些微小核糖核酸分子的药物是否是避免心碎综合征的关键”。