People with Takotsubo syndrome can suddenly experience chest pain, abnormal electrocardiogram results, and elevated levels of cardiac enzymes – all signs that can closely resemble a heart attack. The key difference is that Takotsubo syndrome does not involve blocked coronary arteries. Because the two conditions can look nearly identical at first, many patients undergo invasive cardiac catheterization before doctors can determine what is causing their symptoms.

A New Way To Identify Takotsubo Syndrome

An international team of researchers, working closely with scientists at the universities of Zurich and Greifswald, has developed and validated a diagnostic scoring system designed to identify Takotsubo syndrome before cardiac catheterization is performed.

The new tool, known as the BioTAK score, combines biological sex with several blood biomarkers linked to different processes in the cardiovascular system. Researchers used artificial intelligence to determine which combination of biomarkers provided the most useful diagnostic information and then incorporated those markers into a clinical decision tool.

In an independent validation group of nearly 1,800 additional patients, the BioTAK score identified Takotsubo syndrome with high accuracy. Using predefined thresholds, the system correctly classified nearly 90 percent of participants before they underwent cardiac catheterization.

“Our study shows that a simple combination of blood biomarkers and biological sex can identify these patients with remarkable accuracy even before cardiac catheterization,” says Florian A. Wenzl, co-first author of the study at the Center for Molecular Cardiology at the University of Zurich and the Radcliffe Department of Medicine at the University of Oxford. “At the same time, the biomarkers provide insights into the biological processes that distinguish Takotsubo syndrome from a classic heart attack,” adds co-first author Victor Schweiger of University Hospital Zurich.

Clues to the Brain-Heart Connection

Beyond its potential diagnostic value, the BioTAK score also offers new information about the biology of Takotsubo syndrome. Two newly identified biomarkers included in the score point to an important role for the so-called brain-heart axis and suggest that the condition develops through mechanisms that are separate from atherosclerosis.

One of the proteins helps activate a range of neuropeptides involved in stress responses, anxiety, vascular tone, and autonomic nervous system activity. The other protein is associated with the stability of atherosclerotic plaques. Taken together, the two markers reveal a biological pattern that is fundamentally different from the one typically seen in a classic heart attack.

“By capturing signaling pathways related to stress responses, cardiac dysfunction and plaque stability, the BioTAK score translates complex disease mechanisms into a practical diagnostic tool,” explains co-last author Thomas Lüscher of the National Heart and Lung Institute at Imperial College London.

Potential Use in Emergency Care

The researchers say the BioTAK score could become a useful addition to the early emergency assessment of patients with suspected acute coronary syndrome.

“The BioTAK score is not a substitute for cardiac catheterization when it is medically necessary. However, it could help guide diagnostic procedures more effectively and avoid unnecessary invasive tests in selected patients,” says co-last author Christian Templin, director of the Department of Internal Medicine B at the University Medical Center Greifswald and founder of the InterTAK Registry. “Our goal is to identify patients with Takotsubo syndrome earlier and more reliably in the future, while also gaining a better understanding of the underlying disease mechanisms.”

Further research will examine whether adding the BioTAK score to routine clinical care can improve how Takotsubo syndrome is diagnosed and treated.

Data From Major International Registries

The research drew on prospective patient groups from Switzerland, the SPUM-ACS Registry, and the International Takotsubo (InterTAK) Registry, with cohorts that overlapped in both time and location.

Established in 2010, the InterTAK Registry is one of the world’s largest international research infrastructures focused on Takotsubo syndrome. For the study, published in the European Heart Journal, researchers analyzed data from more than 3,600 patients with either acute coronary syndrome or Takotsubo syndrome.

Published in Nutrients, the study tracked nearly 10,000 women aged 65 and older for 10 years. The researchers examined whether regular coffee and tea consumption was associated with changes in bone mineral density (BMD), an important measure used to assess osteoporosis risk.

Osteoporosis is a major health problem worldwide. It affects roughly one in three women over age 50 and is responsible for millions of fractures each year. Because billions of people drink coffee or tea every day, even small effects on bone health could have broad implications. Previous research on the subject has produced mixed findings, and relatively few studies have followed participants for such a long period.

Tracking Coffee, Tea, and Bone Density

The Flinders University researchers used data from the Study of Osteoporotic Fractures. They repeatedly assessed participants’ beverage habits and measured BMD at both the hip and femoral neck, two areas closely linked to fracture risk.

During the 10-year study period, the women regularly reported how much coffee and tea they drank. Researchers also used advanced imaging methods to monitor changes in their bone density.

The results showed that women who drank tea had slightly higher total hip BMD than those who did not drink tea. The difference was small, but it was statistically significant and could still matter when considered across large populations.

“Even small improvements in bone density can translate into fewer fractures across large groups,” says Adjunct Associate Professor Enwu Liu from the College of Medicine and Public Health.

Heavy Coffee Intake Linked to Lower Bone Density

Coffee showed a more complicated pattern. Drinking moderate amounts, about two to three cups per day, was not associated with harm to bone health. However, women who drank more than five cups a day had lower BMD, suggesting that very high coffee consumption could have negative effects.

The relationship also appeared to differ depending on other health and lifestyle factors. Women with higher lifetime alcohol consumption experienced stronger negative effects associated with coffee, while the apparent benefits of tea were more pronounced among women with obesity.

Ryan Liu, co-author on the paper, says that compounds called catechins, abundant in tea, may promote bone formation and slow bone breakdown.

“Coffee’s caffeine content, by contrast, has been shown in laboratory studies to interfere with calcium absorption and bone metabolism, though these effects are small and can be offset by adding milk,” says Ryan Liu from Flinders University.

A Possible Benefit From Daily Tea

Adjunct Associate Professor Enwu Liu adds that the findings suggest that regularly drinking tea could offer a simple way to support bone health later in life.

“While moderate coffee drinking appears safe, very high consumption may not be ideal, especially for women who drink alcohol,” he says.

The researchers emphasize that the differences they observed were modest. Although the findings were statistically significant, they were not large enough to justify major changes in an individual’s daily habits.

“Our results don’t mean you need to give up coffee or start drinking tea by the gallon,” says Associate Professor Liu.

“But they do suggest that moderate tea consumption could be one simple way to support bone health, and that very high coffee intake might not be ideal, especially for women who drink alcohol.

“While calcium and vitamin D remain cornerstones of bone health, what’s in your cup could play a role too. For older women, enjoying a daily cup of tea may be more than a comforting ritual, it could be a small step toward stronger bones,” he concludes.

The paper, ‘Longitudinal Association of Coffee and Tea Consumption with Bone Mineral Density in Older Women: A 10-Year Repeated-Measures Analysis in the Study of Osteoporotic Fractures’, by Ryan Yan Liu and Enwu Liu was published in Nutrients.

Acknowledgments: The funding for the SOF study comes from the National Institute on Aging (NIA) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), supported by grants (AG05407, AR35582, AG05394, AR35584, and AR35583).

One study from NASA’s SHIELD (Solar Wind with Hydrogen Ion charge Exchange and Large-Scale Dynamics) center, one of NASA’s DRIVE (Diversify, Realize, Integrate, Venture, Educate) Science Centers, examines how the heliosphere moved through the Milky Way over time. The heliosphere is the vast protective bubble produced by the Sun that surrounds the solar system. Researchers found that changes in the galactic environment around this bubble may have affected conditions on Earth.

A separate study led by a NASA scientist explores another ancient puzzle: how a much dimmer young Sun could have kept Earth warm. The findings suggest that powerful solar eruptions may have helped generate strong greenhouse gases in Earth’s early atmosphere.

The Sun’s Journey Through the Milky Way

Earth’s climate has changed dramatically over tens of millions of years. At various points, major ice ages temporarily lowered global average temperatures by several degrees, while other periods brought repeated swings between warmer and colder conditions.

Scientists have traditionally investigated changes in Earth’s orbit, greenhouse gas levels, ice coverage, and other planetary factors to understand these shifts. New research now suggests that changes in the space environment surrounding the Sun may also have played an important role.

The solar system is enclosed within a protective region created by the Sun, somewhat like the way Earth is surrounded by an atmosphere. This region, called the heliosphere, forms as charged particles in the solar wind continuously stream outward from the Sun in every direction.

Reconstructing the Sun’s Galactic Path

The entire heliosphere travels around the center of the Milky Way. During the Sun’s 4.6-billion-year lifetime, the solar system has moved through many different galactic environments.

In a study published on Aug. 21 in Annual Review of Astronomy and Astrophysics, researchers with NASA’s SHIELD center used computer simulations to reconstruct the heliosphere’s past trajectory through the galaxy. Their results suggest that some of the regions the solar system encountered may have produced measurable changes on Earth.

Merav Opher, SHIELD’s principal investigator at Boston University, and her colleagues simulated encounters between the solar system and extremely cold regions filled with gas and dust. Their work indicates that the Sun passed through such environments at least three times during the past several million years.

During these encounters, enormous interstellar “cold clouds” may have pressed against the heliosphere with enough force to dramatically compress it. According to the simulations, the heliosphere may at times have shrunk to a size smaller than Earth’s orbit, temporarily leaving our planet outside the Sun’s protective bubble.

When Earth May Have Lost Its Solar Shield

The modeled encounters occurred approximately 2 to 3 million years ago, 6 to 7 million years ago, and 13 to 14 million years ago. If the heliosphere contracted as the simulations suggest, Earth’s atmosphere would have been directly exposed to a very different interstellar environment during those periods.

The timing also lines up with geological evidence. Elements commonly associated with interstellar dust have been found in deep-sea sediment cores, Antarctic snow, and samples from the Moon that correspond to these time periods.

These episodes of heliosphere collapse may also help explain some ancient climate patterns.

In the simulations, exposing Earth’s atmosphere to a dense, cold cloud of galactic hydrogen increased atmospheric water vapor and changed conditions in the upper atmosphere. Those effects eventually influenced conditions closer to Earth’s surface.

The results raise the possibility that the solar system’s passages through colder parts of the Milky Way contributed to some long-term climate changes on Earth, potentially including ice ages.

Building a Digital Twin of the Heliosphere

NASA funds SHIELD as one of several centers designed to advance the study of heliophysics. As a DRIVE Science Center, SHIELD brings together researchers with different areas of expertise, methods, and scientific perspectives.

One of the center’s goals is to build a detailed model, or “digital twin,” of the heliosphere. This model could help scientists better understand how the Sun’s protective bubble responds when it encounters features such as dense interstellar clouds.

Studying the history and structure of our habitable solar system could also provide clues about how life evolved on Earth. In the future, that knowledge may help researchers identify other star systems capable of supporting habitable worlds.

The Mystery of the Faint Young Sun

A second study focuses on a different problem involving the Sun’s early history.

Vladimir Airapetian, a scientist at NASA’s Goddard Space Flight Center in Greenbelt, Maryland, and his collaborators investigated how early Earth managed to remain warm enough for liquid water when the young Sun produced much less energy than it does today.

About three billion years ago, the Sun was only 70% as bright as it is now. Based on that reduced output, Earth should theoretically have been frozen solid.

Geological evidence tells a different story. Stable liquid water existed on Earth long before then. The contradiction between a relatively warm early Earth and a cooler, dimmer Sun is known as the Faint Young Sun paradox.

A Violent Young Sun May Hold the Answer

Scientists may find clues by examining young stars elsewhere in the Milky Way that resemble the early Sun.

These “toddler” stars are far more active than mature stars. Observations from NASA’s retired Kepler space telescope show that young Sun-like stars can produce enormous superflares on a daily basis, sending high-energy particles racing outward through space.

If the young Sun behaved in a similar way, Airapetian proposes that these energetic particles could have triggered chemical reactions in Earth’s atmosphere that helped warm the planet.

To test that idea, Airapetian’s team recreated conditions thought to resemble the atmosphere of early Earth inside a sealed chamber. The researchers combined molecular nitrogen, ammonia, carbon dioxide, and carbon monoxide.

They then bombarded the gas mixture with protons to imitate the stream of energetic particles generated by solar superflares.

Superflares Could Have Created a Powerful Greenhouse Gas

The simulated particle bombardment produced several chemical changes, including the formation of nitrous oxide. Nitrous oxide is a greenhouse gas roughly 300 times more potent than carbon dioxide. The study was published in Astrophysical Journal Letters.

That nitrous oxide could have helped early Earth retain heat.

Not all of the gas would have remained in the atmosphere, however. Intense ultraviolet radiation from the young Sun would have broken down some nitrous oxide molecules, separating them back into nitrogen and oxygen.

Even so, the researchers found that relatively little nitrous oxide may have been needed.

Computer simulations showed that if just 10% of the nitrous oxide produced in the laboratory experiment survived, it could have raised temperatures near Earth’s equator to around 41 degrees Fahrenheit (5 degrees Celsius). That would have kept temperatures above the freezing point of water.

Conditions That May Have Favored Early Life

A cooler but unfrozen Earth may have offered another advantage.

The smaller surviving amount of nitrous oxide could have supported prebiotic chemical reactions. Research has found that temperatures only slightly above freezing can be more effective than warmer conditions for assembling complex chains of amino acids.

That means the young Sun’s violent activity may have done more than prevent Earth from freezing. It may also have helped create environmental conditions favorable to the chemistry that preceded life.

How the Sun Helped Shape Earth

Together, the two studies highlight how deeply Earth’s history is connected to the Sun.

The solar system’s movement through the Milky Way may have exposed Earth to changing interstellar environments capable of influencing its climate. Billions of years earlier, intense activity from the young Sun may have helped warm the planet when sunlight alone should not have been sufficient.

Earth is unusual in many ways, but it has never existed in isolation. It formed within a larger star-planet system and has remained closely connected to the changing behavior and environment of the Sun throughout its history.

Understanding that relationship could reveal new clues about Earth’s climate, the evolution of life, and the conditions that might make other planetary systems habitable.