ArticleClinical cardiology2010
Possible participation of endothelial cell apoptosis of coronary microvessels in the genesis of Takotsubo cardiomyopathy.
Article in Clinical cardiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- MicroRNAs in Takotsubo Syndrome: A Systematic Review of Regulatory Networks in Stress-Induced Cardiomyopathy.International journal of molecular sciences · 2025Pooled it
- Takotsubo syndrome: Unraveling the mystery behind its triggers (Review).International journal of molecular medicine · 2025Review
- Neurogenic Stunned Myocardium: A Narrative Review of Cardiopulmonary Failure Related to Subarachnoidal Haemorrhage.Cureus · 2025Review
- The Genetic Puzzle of the Stress-Induced Cardiomyopathy (Takotsubo Syndrome): State of Art and Future Perspectives.Biomolecules · 2025Review
- Takotsubo Syndrome and Oxidative Stress: Physiopathological Linkage and Future Perspectives.Antioxidants (Basel, Switzerland) · 2025Review
- Takotsubo Syndrome and Gender Differences: Exploring Pathophysiological Mechanisms and Clinical Differences for a Personalized Approach in Patient Management.Journal of clinical medicine · 2024Review
- Obstructive Hypertrophic Cardiomyopathy and Takotsubo Syndrome: How to Deal With Left Ventricular Ballooning?Journal of the American Heart Association · 2023Review
- Inflammatory Forms of Cardiomyocyte Cell Death in the Rat Model of Isoprenaline-Induced Takotsubo Syndrome.Biomedicines · 2023Article
- Transient stress-related hyperviscosity and endothelial dysfunction in Takotsubo syndrome: a time course study.Heart and vessels · 2022Article
- Coronavirus Disease 2019 and Takotsubo Syndrome.Reviews in cardiovascular medicine · 2022Review
- TakoTsubo Syndrome: First an Acute Coronary Vasculitis and Then Prolonged Myocarditis?Reviews in cardiovascular medicine · 2022Review
- Takotsubo Syndrome: Translational Implications and Pathomechanisms.International journal of molecular sciences · 2022Review
- Isoprenaline induced Takotsubo syndrome: Histopathological analyses of female rat hearts.Cardiology journal · 2022Article
- Endothelin-1 axes in the framework of predictive, preventive and personalised (3P) medicine.The EPMA journal · 2021Review
- Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 1-Pathophysiology and Diagnosis.Journal of clinical medicine · 2021Review
- The Association Between Hyperlipidemia and In-Hospital Outcomes in Takotsubo Cardiomyopathy.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- Takotsubo Syndrome: Clinical Manifestations, Etiology and Pathogenesis.Current cardiology reviews · 2021Article
- Takotsubo Syndrome: Cardiotoxic Stress in the COVID Era.Mayo Clinic proceedings. Innovations, quality & outcomes · 2020Review
- LncRNA LUADT1 sponges miR-195 to prevent cardiac endothelial cell apoptosis in sepsis.Molecular medicine (Cambridge, Mass.) · 2020Article
- Advancements in the diagnostic workup, prognostic evaluation, and treatment of takotsubo syndrome.Heart failure reviews · 2020Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTakotsubo cardiomyopathy (TCM) is characterized by systolic ballooning of the left ventricular apex. It is triggered by emotional or physical stress, but the exact mechanism through which stress leads to TCM is not known. HYPOTHESIS: Coronary microvessel apoptosis is the missing link between stress and TCM.
methodsIn 8 female patients with TCM, plasma catecholamines, Thrombolysis in Myocardial Infarction (TIMI) coronary flow grade and myocardial perfusion grade, and apoptosis of the coronary microvessels in the biopsied myocardial specimen by terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL) were examined.
resultsPlasma epinephrine and norepinephrine were increased to 663 +/- 445 and 875 +/- 812 pg/mL (mean +/- SD), respectively. Acetylcholine-induced delayed myocardial perfusion through the ballooning apical segment without flow disturbance in the epicardial coronary arteries (indicating microvessel spasm) and focal myocardial necrosis were observed in all subjects. Apical ballooning disappeared and myocardial perfusion delay was not inducible 1 month later. The number of vessels having apoptotic endothelial cells/10 vessels in arterioles, venules, and capillaries at initial biopsy and repeat biopsy 1 month later were 8.3 +/- 1.4 vs 0.4 +/- 1.1, P < 0.0001; 6.8 +/- 1.8 vs 0.3 +/- 0.7, P < 0.0001; and 7.9 +/- 1.0 vs 0.5 +/- 0.9, P < 0.0001, respectively.
conclusionsLeft ventricular apical ballooning in TCM was considered to be caused by coronary microvessel spasm due to catecholamine-induced endothelial cell apoptosis and myocardial stunning after release of microvessel spasm. Endothelial cell apoptosis of coronary microvessel is therefore considered to be the missing link between stress and TCM.
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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.