Document Detail

Takotsubo cardiomyopathy is not due to plaque rupture: an intravascular ultrasound study.
MedLine Citation:
PMID:  20513070     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Plaque rupture with subsequent transient thrombotic coronary occlusion by a fast-dissolving clot is one of the proposed pathogenic mechanisms in Takotsubo cardiomyopathy (TC). HYPOTHESIS: The aim of this study was to seek evidence for the hypothesis of transient coronary thrombosis as the underlying mechanism of TC by means of intravascular ultrasound (IVUS). METHODS: In our database of 63 consecutive patients with TC we identified 10 patients (16%) who had undergone IVUS during their initial left heart catheterisation. RESULTS: A median length of 67 mm of the left anterior descending artery was analyzed (interquartile range [IQR]: 63.3-70.1 mm). Median lumen diameter, median vessel diameter, median plaque and media volume were 2.9 mm (IQR: 2.7-3.1 mm), 4.2 mm (IQR: 3.8-4.4 mm), and 90.9 mm(3) (IQR: 70.4-101.4 mm(3)), respectively. Plaque rupture, positive remodeling, and presumed intracoronary thrombus were absent in all patients. CONCLUSION: In conclusion, plaque rupture does not account for the regional wall motion abnormalities observed in TC. The previously reported observation of plaque rupture in TC seems to constitute an incidental finding. We suggest that the theory of aborted myocardial infarction as the underlying cause of TC should be abandoned once and for all.
Dariusch Haghi; Stefanie Roehm; Karsten Hamm; Niels Harder; Tim Suselbeck; Martin Borggrefe; Theano Papavassiliu
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  33     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-31     Completed Date:  2010-09-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  307-10     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Wiley Periodicals, Inc.
First Department of Medicine, University Medical Centre and Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
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MeSH Terms
Aged, 80 and over
Coronary Angiography
Coronary Artery Disease / complications,  ultrasonography*
Coronary Thrombosis / etiology,  ultrasonography*
Evidence-Based Medicine
Retrospective Studies
Risk Factors
Rupture, Spontaneous
Takotsubo Cardiomyopathy / etiology,  ultrasonography*
Ultrasonography, Interventional*

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