{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:51:21Z","timestamp":1785498681472,"version":"3.56.0"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,6,24]],"date-time":"2013-06-24T00:00:00Z","timestamp":1372032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Stress cardiomyopathy manifests as reversible left ventricular apical ballooning in the absence of epicardial coronary obstruction. Transient microcirculatory dysfunction has been proposed as a potential putative mechanism. This study aimed to understand the natural history of this dysfunction using readily available noninvasive methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Stress cardiomyopathy presents with profound microvascular dysfunction that improves quickly over a period of 3 to 4 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nine consecutive patients with Takotsubo cardiomyopathy were followed serially with myocardial perfusion echocardiograms at 24 hours, within 1 week, and 3 to 6 months after index admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean left ventricular ejection fraction (LVEF) steadily improved from 38% at baseline to 48% within 1 week to 67% by the end of 3 to 6 months follow\u2010up. The number of wall segments with reduced or absent perfusion decreased from 4.1 at baseline to 2 at 1 week. By 3 to 6 months, perfusion had returned to normal in all but 1 segment in 1 patient. At 1 week, the relative improvement in mean LVEF was 26%, whereas perfusion had improved by nearly 50%, suggesting a fairly pronounced improvement in microcirculatory function prior to recovery of wall motion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with Takotsubo cardiomyopathy present with significant acute microcirculatory dysfunction that recovers quickly prior to the recovery of regional wall motion abnormalities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22154","type":"journal-article","created":{"date-parts":[[2013,6,24]],"date-time":"2013-06-24T15:38:56Z","timestamp":1372088336000},"page":"531-534","source":"Crossref","is-referenced-by-count":22,"title":["Serial Evaluation of Microcirculatory Dysfunction in Patients With Takotsubo Cardiomyopathy by Myocardial Contrast Echocardiography"],"prefix":"10.1002","volume":"36","author":[{"given":"Mohit","family":"Jain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrikanth","family":"Upadaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart W.","family":"Zarich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01316-X"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000079313.93444.F1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.9.1027"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000153801.51470.EB"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000155234.69439.E4"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.05.065"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.677625"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.69.934"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.04.030"},{"issue":"469","key":"e_1_2_6_11_1","first-page":"e9","article-title":"Myocardial perfusion in apical ballooning syndrome: correlate of myocardial injury","volume":"152","author":"Elesber A","year":"2006","journal-title":"Am Heart J"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2009.07.012"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.046"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(89)80014-8"},{"key":"e_1_2_6_15_1","first-page":"203","article-title":"Myocardial stunning due to simultaneous multi\u2010vessel spasms: a review of five cases","volume":"21","author":"Dote K","year":"1991","journal-title":"J Cardiol."},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20953"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20833"},{"key":"e_1_2_6_18_1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1067\/mhj.2002.120403","article-title":"Takotsubo like left ventricular dysfunction with ST\u2010segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction","volume":"143","author":"Kurisu S","year":"2002","journal-title":"Am Heart J."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl021"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2004.035709"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.21983"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.22154","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.22154","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T14:23:41Z","timestamp":1696343021000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.22154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,24]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2013,9]]}},"alternative-id":["10.1002\/clc.22154"],"URL":"https:\/\/doi.org\/10.1002\/clc.22154","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,24]]}}}