ArticleClinical research in cardiology : official journal of the German Cardiac Society2024
Coronary microvascular dysfunction in Takotsubo syndrome: an analysis using angiography-derived index of microcirculatory resistance.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 10 citations in OpenAlex.
- Cocaine-induced acute myocardial infarction: angiographic features and outcomes.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Spontaneous Coronary Artery Dissection and Takotsubo Syndrome: Converging Mechanisms, Diagnostic Pitfalls, and a Unified Clinical Algorithm.Journal of clinical medicine · 2026Review
- Diagnostic Challenges in Takotsubo Syndrome: Bridging Mimics, Mechanisms, and Management.Journal of clinical medicine · 2026Review
- Angiography-derived assessment of coronary microcirculatory resistance in patients with chronic total occlusion.Heart and vessels · 2026Article
- Prognostic significance of stress hyperglycemia ratio in coronary microvascular dysfunction among chronic coronary syndrome patients.Frontiers in cardiovascular medicine · 2026Article
- Association between the C-reactive protein-triglyceride-glucose index and the presence and prognosis of coronary microvascular dysfunction in patients with chronic coronary syndrome.Frontiers in cardiovascular medicine · 2026Article
- [Rare cases of stress cardiomyopathy triggered by pulmonary embolism and reverse Takotsubo].Revista medica del Instituto Mexicano del Seguro Social · 2026Article
- Takotsubo Syndrome in 2025: Evolving Concepts in Pathophysiology, Diagnosis, and Long-Term Management.Journal of clinical medicine · 2025Review
- Takotsubo Cardiomyopathy: An Exploration of the Intersection Between Stress, Coronary Dysfunction, and Cardiac Outcomes.Reviews in cardiovascular medicine · 2025Review
- Heart-Brain axis: is microvascular dysfunction the link between stroke and Takotsubo syndrome?The international journal of cardiovascular imaging · 2025Review
- Takotsubo syndrome following mitral transcatheter edge-to-edge repair: a case report and literature review.Frontiers in cardiovascular medicine · 2025Article
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20 authors at 1 institution in 1 country.
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Abstract
backgroundCoronary microvascular dysfunction (CMD) has been proposed as a crucial factor in the pathophysiology of Takotsubo syndrome (TTS). The angiography-derived index of microcirculatory resistance (caIMR) offers an alternative to conventional hyperemic wire-based IMR to assess CMD. We aimed to evaluate CMD's prevalence, transience, and impact on in-hospital outcomes in TTS.
methodsAll three coronary arteries of 96 patients with TTS were assessed for their coronary angiography derived Index of microcirculatory Resistance (caIMR) and compared to non-obstructed vessels of matched patients with ST-elevation myocardial infarction. Further, the association between caIMR and the TTS-specific combined in-hospital endpoint of death, cardiac arrest, ventricular arrhythmogenic events and cardiogenic shock was investigated.
resultsElevated IMR was present in all TTS patients, with significantly elevated caIMR values in all coronary arteries compared to controls. CaIMR did not differ between apical and midventricular TTS types. CaIMR normalized in TTS patients with follow-up angiographies performed at a median of 28 months (median caIMR at event vs follow-up: LAD 34.8 [29.9-41.1] vs 20.3 [16.0-25.3], p < 0.001; LCX: 38.7 [32.9-50.1] vs 23.7 [19.4-30.5], p < 0.001; RCA: 31.7 [25.0-39.1] vs 19.6 [17.1-24.0], p < 0.001). The extent of caIMR elevation significantly correlated with the combined in-hospital endpoint (p = 0.036).
conclusionTTS patients had evidence of elevated caIMR in at least one coronary artery with a trend towards higher LAD caIMR in apical type TTS and normalization after recovery. Furthermore, extent of caIMR elevation was associated with increased risk of in-hospital MACE of TTS patients.
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