Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of right ventricle functions and serotonin levels during headache attacks in migraine patients with aura

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Several studies suggested that headache attacks and its frequency were mainly responsible for increased cardiovascular (CV) disease and mortality in patients with migraine with aura (MWA). Elevated serotonin level has been found to play a role in migraine attacks. Serotonin was best studied within the CV system for its role in the development of pulmonary hypertension, which had negative impact on right ventricular (RV) functions. Therefore, in this study we aimed to evaluate RV functions during headache attacks in MWA patients and its relation to attack frequency with the utility of 2-dimensional speckle tracking echocardiography (2D STE). Fifty-three patients with the diagnosis of MWA were enrolled in the study. All patients were evaluated by conventional and 2D-STE echocardiography and venous blood sampling for serotonin was obtained during headache-free period (HFP) and headache-attack period (HAP). Also, patients were divided into two groups according to attack frequency. Patients exhibited higher serotonin levels during HAP than HFP (p < 0.001). Regarding 2D-STE derived RV-free-strain parameters, patients had lower RV-free wall longitudinal speckle-tracking strain (RV-free-ST), RV-free systolic strain rate (RV-free-STR-S), RV-free early diastolic strain rate (RV-free-STR-E) and RV-free-STR-E/A ratio levels during HAP when compared with HFP (p 0.002, p 0.006, p < 0.001 and p 0.001, respectively). Thirty-one patients (58.4 %) had low-frequency attack. Patients with high-frequency attacks had increased serotonin levels (p 0.040) and decreased RV-free-ST, RV-free-STR-S, RV-free-STR-E and RV-free-STR-E/A ratio values during HAP when compared to low-frequency group (p 0.026, p 0.029, p 0.037 and p 0.019 respectively). This study demonstrated that migraine attacks, especially at higher frequencies, could have negative impact on RV systolic functions in MWA patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

MWA:

Migraine with aura

CV:

Cardiovascular

PHT:

Pulmonary hypertension

PASP:

Pulmonary artery systolic pressure

RV:

Right ventricle

2D-STE:

Two-dimensional speckle tracking echocardiography

HFP:

Headache free period

HAP:

Headache attack period

LVEF:

Left ventricle ejection fraction

TAPSE:

Tricuspid annular plane systolic

MPI:

Myocardial performance index

IVA:

Isovolumic acceleration

TTE:

Transthoracic echocardiography

TEE:

Transesophageal echocardiography

PFO:

Patent foramen ovale

RV-free-ST:

RV-free wall longitudinal speckle-tracking strain

RV-free-STR-S:

RV-free systolic strain rate

RV-free-STR-E:

RV-free early diastolic strain rate

5-HTT:

Serotonin transporter

References

  1. Schürks M, Rist PM, Shapiro RE, Kurth T (2011) Migraine and mortality: a systematic review and meta-analysis. Cephalalgia 3:30–34 (Review)

    Google Scholar 

  2. Kurth T, Schürks M, Logroscino G, Gaziano JM, Buring JE (2008) Migraine, vascular risk, and cardiovascular events in women: prospective cohort study. BMJ 337:636

    Article  Google Scholar 

  3. Winsvold BS, Sandven I, Hagen K, Linde M, Midthjell K, Zwart JA (2013) Migraine, headache and development of metabolic syndrome: an 11-year follow-up in the Nord-Trøndelag Health Study (HUNT). Pain 154:1305–1311

    Article  PubMed  Google Scholar 

  4. Vidalón M (2006) Subclinical left ventricular dysfunction in migraine attacks. Headache 46:46–56

    Article  PubMed  Google Scholar 

  5. Bigal ME, Kurth T, Hu H, Santanello N, Lipton RB (2009) Migraine and cardiovascular disease: possible mechanisms of interaction. Neurology 72:1864–1871 (Review)

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  6. Gudmundsson LS, Scher AI, Aspelund T, Eliasson JH, Johannsson M, Thorgeirsson G, Launer L, Gudnason V (2010) Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study. BMJ 341:3966

    Article  Google Scholar 

  7. Kurth T, Schürks M, Logroscino G, Buring JE (2009) Migraine frequency and risk of cardiovascular disease in women. Neurology 73:581–588

    Article  PubMed  PubMed Central  Google Scholar 

  8. Park KE, Pepine CJ (2010) Pathophysiologic mechanisms linking impaired cardiovascular health and neurologic dysfunction: the year in review. Cleve Clin J Med 77:40–45

    Article  Google Scholar 

  9. Nagai T, Tabara Y, Igase M, Nakura J, Miki T, Kohara K (2007) Migraine is associated with enhanced arterial stiffness. Hypertens Res 30:577–583

    Article  PubMed  Google Scholar 

  10. Stronks DL, Tulen JH, Verheij R, Boomsma F, Fekkes D, Pepplinkhuizen L, Mantel GW, Passchier J (1998) Serotonergic, catecholaminergic, and cardiovascular reactions to mental stress in female migraine patients. A controlled study. Headache 38:270–280

    Article  PubMed  CAS  Google Scholar 

  11. Hardegree EL, Sachdev A, Villarraga HR, Frantz RP, McGoon MD, Kushwaha SS, Hsiao JF, McCully RB, Oh JK, Pellikka PA, Kane GC (2013) Role of serial quantitative assessment of right ventricular function by strain in pulmonary arterial hypertension. Am J Cardiol 111:143–148

    Article  PubMed  Google Scholar 

  12. Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, Nesser HJ, Khandheria B, Narula J, Sengupta PP (2010) Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr 23:351–369

    Article  PubMed  Google Scholar 

  13. Altekin RE, Karakas MS, Yanikoglu A, Ozel D, Ozbudak O, Demir I, Deger N (2012) Determination of right ventricular dysfunction using the speckle tracking echocardiography method in patients with obstructive sleep apnea. Cardiol J 19:130–139

    Article  PubMed  Google Scholar 

  14. Classification Committee of the International Headache Society (2004) The ınternational classification of headache disorders. 2nd Edition. Cephalalgia 24:1–149

    Google Scholar 

  15. Imai E, Horio M, Nitta K, Yamagata K, Iseki K, Tsukamoto Y, Ito S, Makino H, Hishida A, Matsuo S (2007) Modification of the modification of diet in renal disease (MDRD) study equation for Japan. Am J Kidney Dis 50:927–937

    Article  PubMed  Google Scholar 

  16. Gottdiener JS, Bednarz J, Devereux R, Gardin J, Klein A, Manning WJ, Morehead A, Kitzman D, Oh J, Quinones M, Schiller NB, Stein JH, Weissman NJ (2004) American society of echocardiography: recommendations for use of echocardiography in clinical trials; a report from the American society of echocardiography. J Am Soc Echocardiogr 17:1086–1119

    PubMed  Google Scholar 

  17. Vargas BB, Dodick DW, Wingerchuk DM, Demaerschalk BM (2008) Migraine with and without aura and risk for cardiovascular disease. Curr Atheroscler Rep 10:427–433 (Review)

    Article  PubMed  Google Scholar 

  18. Stam AH, Weller CM, Janssens AC, Aulchenko YS, Oostra BA, Frants RR, van den Maagdenberg AM, Ferrari MD, van Duijn CM, Gisela MT (2013) Migraine is not associated with enhanced atherosclerosis. Cephalalgia 33:228–235

    Article  PubMed  Google Scholar 

  19. Hamel E (2007) Serotonin and migraine: biology and clinical implications. Cephalalgia 27:1293–1300 (Review)

    Article  PubMed  CAS  Google Scholar 

  20. Ferrari MD, Saxena PR (1993) On serotonin and migraine: a clinical and pharmacological review. Cephalalgia 13:151–165 (Review)

    Article  PubMed  CAS  Google Scholar 

  21. Humphrey PP (1991) 5-Hydroxytryptamine and the pathophysiology of migraine. J Neurol 238:38–44 (Review)

    Article  Google Scholar 

  22. Panconesi A (2008) Serotonin and migraine: a reconsideration of the central theory. J Headache Pain 9:267–276 (Review)

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  23. Yıldız A, Kaya H, Ertaş F, Oylumlu M, Bilik MZ, Yüksel M, Polat N, Akil MA, Atılgan Z, Ulgen MS (2013) Association between neutrophil to lymphocyte ratio and pulmonary arterial hypertension. Turk Kardiyol Dern Ars 41:604–609

    Article  PubMed  Google Scholar 

  24. Eddahibi S, Humbert M, Fadel E, Raffestin B, Darmon M, Capron F, Simonneau G, Dartevelle P, Hamon M, Adnot S (2001) Serotonin transporter overexpression is responsible for pulmonary artery smooth muscle hyperplasia in primary pulmonary hypertension. J Clin Invest 108:1141–1150

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  25. Yilmaz M, Erdal ME, Herken H, Cataloluk O, Barlas O, Bayazit YA (2001) Significance of serotonin transporter gene polymorphism in migraine. J Neurol Sci 186:27–30

    Article  PubMed  CAS  Google Scholar 

  26. Machado RD, Koehler R, Glissmeyer E, Veal C, Suntharalingam J, Kim M, Carlquist J, Town M, Elliott CG, Hoeper M, Fijalkowska A, Kurzyna M, Thomson JR, Gibbs SR, Wilkins MR, Seeger W, Morrell NW, Gruenig E, Trembath RC, Janssen B (2006) Genetic association of the serotonin transporter in pulmonary arterial hypertension. Am J Respir Crit Care Med 173:793–797

    Article  PubMed  CAS  Google Scholar 

  27. Ventetuolo CE, Barr RG, Bluemke DA, Jain A, Delaney JA, Hundley WG, Lima JA, Kawut SM (2012) Selective serotonin reuptake inhibitor use is associated with right ventricular structure and function: the MESA-right ventricle study. PLoS ONE 7:30480

    Article  Google Scholar 

  28. López-Candales A, Rajagopalan N, Dohi K, Gulyasy B, Edelman K, Bazaz R (2007) Abnormal right ventricular myocardial strain generation in mild pulmonary hypertension. Echocardiography 24:615–622

    Article  PubMed  Google Scholar 

  29. Fukuda Y, Tanaka H, Sugiyama D, Ryo K, Onishi T, Fukuya H, Nogami M, Ohno Y, Emoto N, Kawai H, Hirata K (2011) Utility of right ventricular free wall speckle-tracking strain for evaluation of right ventricular performance in patients with pulmonary hypertension. J Am Soc Echocardiogr 24:1101–1108

    Article  PubMed  Google Scholar 

  30. Pierangeli G, Giannini G, Favoni V, Sambati L, Cevoli S, Cortelli P (2012) Migraine and cardiovascular diseases. Neurol Sci 33(Suppl 1):S47–S50 (Review)

    Article  PubMed  Google Scholar 

  31. Sathasivam S, Sathasivam S (2013) Patent foramen ovale and migraine: what is the relationship between the two? J Cardiol 61:256–259

    Article  PubMed  Google Scholar 

  32. Maffè S, Dellavesa P, Zenone F, Paino AM, Paffoni P, Perucca A, Kozel D, Signorotti F, Bielli M, Parravicini U, Pardo NF, Cucchi L, Aymele AG, Zanetta M (2010) Transthoracic second harmonic two- and three-dimensional echocardiography for detection of patent foramen ovale. Eur J Echocardiogr 11:57–63

    Article  PubMed  Google Scholar 

  33. López-Candales A, Dohi K, Rajagopalan N, Suffoletto M, Murali S, Gorcsan J, Edelman K (2005) Right ventricular dyssynchrony in patients with pulmonary hypertension is associated with disease severity and functional class. Cardiovasc Ultrasound 29(3):23

    Article  Google Scholar 

Download references

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Soguksu Mah., Camlık Cad, 61040, Trabzon, Turkey

    Ezgi Kalaycıoğlu, Ahmet Çağrı Aykan, İlker Gül & Şükrü Çelik

  2. Department of Cardiology, Kars Kafkas Medical Faculty, Kars, Turkey

    Tayyar Gökdeniz

  3. Department of Cardiology, Gaziemir State Hospital, Izmir, Turkey

    Mustafa Ozan Gürsoy

  4. Department of Neurology, Kanuni Education and Research Hospital, Trabzon, Turkey

    Numan Ayhan

Authors
  1. Ezgi Kalaycıoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tayyar Gökdeniz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmet Çağrı Aykan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mustafa Ozan Gürsoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. İlker Gül
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Numan Ayhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Şükrü Çelik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ezgi Kalaycıoğlu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kalaycıoğlu, E., Gökdeniz, T., Aykan, A.Ç. et al. Evaluation of right ventricle functions and serotonin levels during headache attacks in migraine patients with aura. Int J Cardiovasc Imaging 30, 1255–1263 (2014). https://doi.org/10.1007/s10554-014-0456-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-014-0456-2

Keywords

Search

Navigation