title: An angiographic and intravascular ultrasound study of the left anterior descending coronary artery in takotsubo cardiomyopathy.
abstract: The precise cause of takotsubo cardiomyopathy (TC) remains controversial. Plaque rupture with transient thrombotic occlusion of a transapical left anterior descending coronary artery (LAD) has been advanced as a potential mechanism. To explore this hypothesis, the investigators analyzed data from 11 patients prospectively enrolled in the Rhode Island Takotsubo Cardiomyopathy Registry who underwent coronary angiography and intravascular ultrasound evaluation of the LAD during their initial presentation. Despite the presence of nonobstructive coronary artery disease, no culprit lesion was identified in any patient. Similarly, the course of the LAD failed to account for the characteristic left ventricular apical ballooning seen in TC. In conclusion, an atherosclerotic coronary lesion in the LAD causing an aborted myocardial infarction may not be the primary underlying cause of TC, and nonobstructive coronary artery disease and TC may coexist without a direct causal association.
authors: Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. atruesdell@lifespan.org
authors: Gabriel A
authors: GA
authors: Delgado
authors: Alexander G
authors: AG
authors: Truesdell
authors: Robert M
authors: RM
authors: Kirchner
authors: Ryan W
authors: RW
authors: Zuzek
authors: Eugene V
authors: EV
authors: Pomerantsev
authors: Paul C
authors: PC
authors: Gordon
authors: Richard A
authors: RA
authors: Regnante
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012237:Rhode Island; D018570:Risk Assessment; D012307:Risk Factors; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional