title: The role of optical coherence tomography in clarifying the mechanisms for dobutamine stress echocardiography-induced takotsubo cardiomyopathy.
abstract: Takotsubo cardiomyopathy is a clinical disorder characterized by a transient dilatation and akynesis or dyskinesis of the left ventricular (LV) apex, mimicking an anterior wall acute myocardial infarction in the absence of significant coronary artery disease (CAD). It typically occurs during an episode of severe emotional or physical stress. Recent reports suggested the potential of dobutamine stress echocardiography (DSE) in inducing the aforementioned syndrome. The transient dysfunction of the LV does not fit any known coronary distribution. Furthermore, there is no obstructive CAD demonstrated at angiography to account for the observed dysfunction. Consequently, the pathophysiology of this syndrome is still undetermined. Here, we report a case of DSE-induced Takotsubo cardiomyopathy in which high-resolution intracoronary imaging was utilized to exclude possible vessel alterations to help provide potential mechanistic explanations for the development of this condition.
authors.affiliation: Division of Interventional Cardiology, Santa Maria alle Scotte Hospital, Siena, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Fineschi
authors.forename: Flavio
authors.initials: F
authors.lastname: D'Ascenzi
authors.forename: Vasile
authors.initials: V
authors.lastname: Sirbu
authors.forename: Sergio
authors.initials: S
authors.lastname: Mondillo
authors.forename: Carlo
authors.initials: C
authors.lastname: Pierli
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D025401:Echocardiography, Stress / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012380:Role; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000209:etiology*; D041623:Tomography, Optical Coherence / Q000379:methods*