Objective: The aim of this study was to elucidate the role of coronary microvascular function in the pathophysiological scenario of Takotsubo cardiomyopathy.
Methods: Noninvasive evaluations of coronary flow reserve through transthoracic Doppler ultrasound imaging of the left anterior descending coronary artery, a reliable marker of coronary microcirculation performance in the absence of epicardial coronary artery stenosis, were performed both in the acute and recovery phases of Takotsubo cardiomyopathy in consecutive patients strictly selected on the basis of absence of risk factors, concomitant diseases, or both impairing coronary microvascular function.
Results: Resting and hyperemic diastolic flow velocity tracings and corresponding velocity time integrals were obtained in seven consecutive patients, six of them women, aged 65-86 years (76 +/- 6.5) at admission and 23 +/- 4 days after, when left ventricular wall motion alterations recovered. In addiction, thrombolysis in myocardial infarction frame count of the two branches of the left coronary artery was evaluated on the cineangiogram obtained at admission. It was normal in both branches of the left coronary artery (left anterior descending, 30.6 +/- 8.79; circumflex, 23.4 +/- 2.96). In each patient, coronary flow reserve, calculated both on velocity time integrals (2.6 +/- 0.2) and average peak diastolic blood flow velocity (2.48 +/- 0.1) values, was in the normal range (>2.0) and did not significantly change when reevaluated in the recovery phase (2.55 +/- 0.1, 2.44 +/- 0.1).
Conclusion: These data suggest that coronary microvascular function may not be impaired in Takotsubo patients when negative influences on coronary flow reserve by concomitant diseases and coronary risk factors are excluded. Its noninvasive evaluation with transthoracic Doppler ultrasound of the distal left anterior descending appears simple and useful in this type of patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2459/JCM.0b013e328313e890 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Subendocardial ischemia: does CMD really exist?
Cardiovasc Revasc Med
January 2025
Weatherhead PET Imaging Center, Division of Cardiology, Department of Medicine, McGovern Medical School at UTHealth and Memorial Hermann Hospital, Houston, TX, United States of America.
Patients with angina but without obstructive epicardial coronary disease still require a specific mechanistic diagnosis to enable targeted treatment. The overarching term "coronary microvascular dysfunction" (CMD) has been applied broadly - but is it correct? We present a series of case examples culminating a systematic exploration of our large clinical database to distinguish among four categories of coronary pathophysiology. First, by far the largest group of "no stenosis angina" patients exhibits subendocardial ischemia during intact flow through diffuse epicardial disease during dipyridamole vasodilator stress.
View Article and Find Full Text PDFThe fetal cerebral Doppler in the last weeks of pregnancy can select very small fetuses unlikely to present intrapartum compromise.
J Matern Fetal Neonatal Med
December 2025
Fetal Medicine Unit, St George's Hospital, London, UK.
Objective: To evaluate whether, in late pregnancy, the cerebral Doppler can identify very small fetuses that are less likely to experience intrapartum compromise (IC).
Material And Methods: This was a retrospective study of 282 singleton pregnancies that underwent an ultrasound scan at 32 + 0- 40 + 6 weeks and were delivered after induction, or spontaneous onset of labor. Very small fetuses were defined as fetuses with estimated weight less than the 3rd centile.
Residing in areas with high residential greenspace is associated with increased COPD risk and decreased lung function of adults in eastern China.
Heart Lung
January 2025
Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China. Electronic address:
Background: Evidence for a relation between residential greenspace and respiratory health is scarce and controversial.
Objectives: The purpose of this study was to explore the association between residential greenspace and its interaction with particulate matter (PM) and risk of chronic obstructive pulmonary disease (COPD) and lung function.
Methods: A total of 3,759 adults were recruited from Wenzhou in this study.
MRI-based modelling of left atrial flow and coagulation to predict risk of thrombogenesis in atrial fibrillation.
Med Image Anal
January 2025
School of Biomedical Engineering and Imaging Sciences, King's College London, UK. Electronic address:
Atrial fibrillation (AF), impacting nearly 50 million individuals globally, is a major contributor to ischaemic strokes, predominantly originating from the left atrial appendage (LAA). Current clinical scores like CHA₂DS₂-VASc, while useful, provide limited insight into the pro-thrombotic mechanisms of Virchow's triad-blood stasis, endothelial damage, and hypercoagulability. This study leverages biophysical computational modelling to deepen our understanding of thrombogenesis in AF patients.
View Article and Find Full Text PDFA Novel Valveless Pulsatile Flow Pump for Extracorporeal Blood Circulation.
Ann Biomed Eng
January 2025
BioCardioLab, Fondazione Toscana G. Monasterio, 54100, Massa, Italy.
Extracorporeal Membrane Oxygenation (ECMO) is a modality of extracorporeal life support which allows temporary support in cases of cardiopulmonary failure and cardiogenic shock. This study presents a valveless pump that works by the Liebau effect as a possible pumping system in ECMO circuits, replacing the current roller and centrifugal pumps. For this purpose, a mock circulatory loop emulating the haemodynamic of the right part of the heart has been constructed.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!