Takotsubo cardiomyopathy is not due to plaque rupture: an intravascular ultrasound study.

Abstract:

BACKGROUND:Plaque rupture with subsequent transient thrombotic coronary occlusion by a fast-dissolving clot is one of the proposed pathogenic mechanisms in Takotsubo cardiomyopathy (TC). HYPOTHESIS:The aim of this study was to seek evidence for the hypothesis of transient coronary thrombosis as the underlying mechanism of TC by means of intravascular ultrasound (IVUS). METHODS:In our database of 63 consecutive patients with TC we identified 10 patients (16%) who had undergone IVUS during their initial left heart catheterisation. RESULTS:A median length of 67 mm of the left anterior descending artery was analyzed (interquartile range [IQR]: 63.3-70.1 mm). Median lumen diameter, median vessel diameter, median plaque and media volume were 2.9 mm (IQR: 2.7-3.1 mm), 4.2 mm (IQR: 3.8-4.4 mm), and 90.9 mm(3) (IQR: 70.4-101.4 mm(3)), respectively. Plaque rupture, positive remodeling, and presumed intracoronary thrombus were absent in all patients. CONCLUSION:In conclusion, plaque rupture does not account for the regional wall motion abnormalities observed in TC. The previously reported observation of plaque rupture in TC seems to constitute an incidental finding. We suggest that the theory of aborted myocardial infarction as the underlying cause of TC should be abandoned once and for all.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Haghi D,Roehm S,Hamm K,Harder N,Suselbeck T,Borggrefe M,Papavassiliu T

doi

10.1002/clc.20747

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

307-10

issue

5

eissn

0160-9289

issn

1932-8737

journal_volume

33

pub_type

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