title: Reversible ventricular dysfunction takotsubo cardiomyopathy.
abstract: BACKGROUND
  Recently, many cardiologists have recognized the existence of a rapidly reversible form of heart failure of unknown origin characterized by a takotsubo-shaped, dyskinetic left ventricle on left ventriculography.
  
  
  OBJECTIVE
  To determine the detailed clinical features of takotsubo cardiomyopathy.
  
  
  METHODS
  Thirteen elderly patients (11 women and 2 men with a mean age of 75.3 years) who had normal coronary arteries and takotsubo-like left ventricular dysfunction were prospectively enrolled in this study.
  
  
  RESULTS
  Cardiac enzymes did not increase significantly, but the mean plasma norepinephrine level was very high on admission (0.98 microg/l). Coronary angiography revealed normal coronary arteries in all patients, but left ventriculography showed apical akinesis combined with basal hyperkinesis, i.e., a takotsubo (Japanese octopus fishing pot)-shaped ventricle. Left ventricular wall motion normalized within a mean of 16.9 hospital days in 12 patients, but 1 patient died of acute renal failure on hospital day 7. Cardiac events did not recur during a follow-up period of 0.5 to 5 years.
  
  
  CONCLUSIONS
  Takotsubo cardiomyopathy seems to be a new type of acute heart failure, which generally has a good prognosis and does not recur. Myocardial damage by catecholamine overload, adrenoceptor hypersensitivity, and changes of catecholamine dynamics due to stress may cause this condition.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki-city, Kanagawa-prefecture, Japan.
authors.forename: Yoshihiro J
authors.initials: YJ
authors.lastname: Akashi
authors.forename: Haruki
authors.initials: H
authors.lastname: Musha
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kida
authors.forename: Kae
authors.initials: K
authors.lastname: Itoh
authors.forename: Koji
authors.initials: K
authors.lastname: Inoue
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kawasaki
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miyake
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D018450:Disease Progression; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009638:Norepinephrine / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D009638:Norepinephrine