ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
Regional alterations in myocardial sympathetic innervation in patients with transient left-ventricular apical ballooning (Tako-Tsubo cardiomyopathy).
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04695587 (The Role of Sympathetic Tone Regarding the Anatomical and Functional Recovery of the Left Ventricle in TakoTsubo Syndrome), which is not on this map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Role of Sympathetic Tone Regarding the Anatomical and Functional Recovery of the Left Ventricle in TakoTsubo Syndrome
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- MicroRNAs in Takotsubo Syndrome: A Systematic Review of Regulatory Networks in Stress-Induced Cardiomyopathy.International journal of molecular sciences · 2025Pooled it
- Update of the Brazilian Guideline on Nuclear Cardiology - 2020.Arquivos brasileiros de cardiologia · 2020Guideline
- Sympathetic nerve activity and response to physiological stress in Takotsubo syndrome.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Trial
- Neurocardiology: Brain-Heart Interactions in the Heart.MedComm · 2026Review
- Cardiac Sympathetic Nerve Terminals in the Pathogenesis of Takotsubo Syndrome: A Brief Review and Novel Analytical Approach.Reviews in cardiovascular medicine · 2026Review
- Takotsubo syndrome: Unraveling the mystery behind its triggers (Review).International journal of molecular medicine · 2025Review
- The neuronal imaging in cardiology: 123I-Biophysical reviews · 2025Review
- Takotsubo syndrome: unravelling the enigma of the broken heart syndrome?-a narrative review.Cardiovascular diagnosis and therapy · 2023Review
- A Review of Nuclear Imaging in Takotsubo Cardiomyopathy.Life (Basel, Switzerland) · 2022Review
- Heritable and non-heritable uncommon causes of stroke.Journal of neurology · 2021Review
- Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 1-Pathophysiology and Diagnosis.Journal of clinical medicine · 2021Review
- Takotsubo Syndrome: Clinical Manifestations, Etiology and Pathogenesis.Current cardiology reviews · 2021Article
- Takotsubo Syndrome: Optimizing Care with a Multidisciplinary Approach.Journal of multidisciplinary healthcare · 2021Review
- The role of multimodality imaging in takotsubo cardiomyopathy.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Review
- International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology.European heart journal · 2018Article
- Exploring the Pathophysiology of Takotsubo Cardiomyopathy.Current cardiology reports · 2017Review
- The natural history of takotsubo syndrome: a two-year follow-up study with myocardial sympathetic and perfusion G-SPECT imaging.European journal of nuclear medicine and molecular imaging · 2017Article
- Rare case of stress cardiomyopathy due to intramuscular epinephrine administration.BMJ case reports · 2016Article
- Takotsubo cardiomyopathy associated with thyrotoxicosis: a case report and review of the literature.Thyroid : official journal of the American Thyroid Association · 2014Review
- Broken heart syndrome, neurogenic stunned myocardium and stroke.Current treatment options in cardiovascular medicine · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExcess sympathetic nervous activity was proposed to play a crucial role in the pathogenesis of transient left-ventricular apical ballooning (TLVAB, also known as Tako-Tsubo cardiomyopathy). This study was conducted to assess presynaptic adrenergic alterations in the dysfunctional myocardium of patients with TLVAB. METHODS AND
resultsTen consecutive patients undergoing coronary angiography for acute coronary syndrome who fulfilled the proposed Mayo Clinic criteria for the diagnosis of TLVAB were investigated. Myocardial iodine-123 metaiodobenzylguanidine ((123)I-MIBG) studies (planar and single-photon emission computed tomography [SPECT]) were performed to evaluate adrenergic innervation. Concomitantly, myocardial perfusion was assessed by means of technetium-99m methoxyisobutylisonitrile ((99m)Tc-MIBI) SPECT. In all patients, angiography revealed typical ballooning of the left-ventricular (LV) apex and hyperkinesis of the basal LV segments (overall ejection fraction, 41% +/- 5% [mean +/- SEM]). Planar (123)I-MIBG scans revealed decreased heart-to-mediastinum ratios at early (20 minutes) and delayed (4 hours) images (2.1 +/- 0.1 and 1.9 +/- 0.1, respectively). The cardiac washout rate of (123)I-MIBG on the late images was increased to 34% +/- 3%. The (123)I-MIBG uptake on SPECT scans was obviously reduced in the akinetic LV apex (defect score, 3.30 +/- 0.34), whereas (99m)Tc-MIBI SPECT indicated normal or only mildly reduced perfusion within this region (defect score, 0.89 +/- 0.35).
conclusionsOur study indicates a functional alteration in presynaptic sympathetic neurotransmission in patients with TLVAB, and suggests a pathophysiologic explanation of the impairment of LV function.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.