Dobutamine Stress Echocardiography and Takotsubo Syndrome: Could Milder Forms of this Pathology Confound the Diagnostic Value of the Test?

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“…1 We agree that Takotsubo cardiomyopathy can be pathologically linked to a cardiomyocytebased, "neuro-mechanical" influence. Madias interestingly hypothesized different patterns of wall contraction abnormalities between dobutamine stress echocardiography (DSE)-induced Takotsubo and ischemia.…”

“…Madias interestingly hypothesized different patterns of wall contraction abnormalities between dobutamine stress echocardiography (DSE)-induced Takotsubo and ischemia. 1 We agree that Takotsubo cardiomyopathy can be pathologically linked to a cardiomyocytebased, "neuro-mechanical" influence. 1 In our case, using a intracoronary imaging technique with a high resolution, we demonstrated that DES-induced Takotsubo cardiomyopathy cannot be attributed to plaque complications, in agreement with a reported spontaneous Takotsubo case report 2 and contrary to previous intravascular ultrasound-based analysis published by Ibanez and colleagues.…”

“…1 We agree that Takotsubo cardiomyopathy can be pathologically linked to a cardiomyocytebased, "neuro-mechanical" influence. 1 In our case, using a intracoronary imaging technique with a high resolution, we demonstrated that DES-induced Takotsubo cardiomyopathy cannot be attributed to plaque complications, in agreement with a reported spontaneous Takotsubo case report 2 and contrary to previous intravascular ultrasound-based analysis published by Ibanez and colleagues. 3 The exact pathophysiology of Takotsubo remains incompletely understood, although cathecolamine excess is widely accepted as a probable contributing factor.…”