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1: Circ J. 2005 Aug;69(8):934-9. Links
Comment in:
Circ J. 2005 Nov;69(11):1428; author reply 1428.

Assessment of coronary microcirculation in patients with takotsubo-like left ventricular dysfunction.

Kume T, Akasaka T, Kawamoto T, Yoshitani H, Watanabe N, Neishi Y, Wada N, Yoshida K.

Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan. tteru@med.kawasaki-m.ac.jp

BACKGROUND: The precise mechanism of takotsubo-like left ventricular (LV) dysfunction remains unclear. METHODS AND RESULTS: Eight consecutive patients with takotsubo-like LV dysfunction were studied. In the acute phase and 3 weeks later, the coronary flow velocity spectrum and coronary flow velocity reserve (CFVR) were recorded by Doppler guidewire. The deceleration time of diastolic velocity (DDT; ms) was measured from the peak diastolic velocity to the point where the extrapolated line intersected the baseline. In all cases, CFVR of the 3 coronary arteries increased during follow-up (1.7+/-0.5 to 2.4+/-0.5 for the left anterior descending artery (p < 0.05), 1.7+/-0.5 to 2.7+/-0.8 for the left circumflex artery (p < 0.05) and 1.7+/-0.3 to 2.5+/-0.4 for the right coronary artery (p < 0.05)). In addition, the DDT of all coronary arteries increased during follow-up. CONCLUSIONS: Decreased CFVR and short DDT were demonstrated in patients with takotsubo-like transient LV dysfunction in the acute phase, and these findings improved 3 weeks later, which suggests that coronary microvascular dysfunction may be a causative mechanism.

PMID: 16041162 [PubMed - indexed for MEDLINE]