Takotsubo Cardiomyopathy—Navigating the Challenges of Diagnosis and Management in Heart Transplantation

Pathophysiology of Takotsubo Syndrome After Cardiac Transplantation

“…1 I wonder whether the donor had one or more transthoracic echocardiograms (TTE) showing depressed left ventricular ejection fraction (LVEF) with eventual partial or complete recovery, considering that this is a frequent encounter, as the authors discussed. 1 Indeed a transiently decreased LVEF in the donor's TTE does not preclude use of the heart as a donor's graft, since it has been noted that such grafts subsequently perform well after CTx. 1 Partial or complete recovery of LVEF in TTEs of the donor's heart would cast doubt on the authors' assertion, that the TTS emergence in the recipient could be attributed to the donor's preceded brain injury.…”

“…1 Indeed a transiently decreased LVEF in the donor's TTE does not preclude use of the heart as a donor's graft, since it has been noted that such grafts subsequently perform well after CTx. 1 Partial or complete recovery of LVEF in TTEs of the donor's heart would cast doubt on the authors' assertion, that the TTS emergence in the recipient could be attributed to the donor's preceded brain injury. Also, if a baseline transesophageal echocardiogram (TEE) in the recipient prior to the use of epinephrine had been available, showing normal LVEF, the authors' contention about the mechanism of the eventual emergence of TTS would be refuted.…”