{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T13:54:27Z","timestamp":1793714067564,"version":"4.6.1"},"reference-count":99,"publisher":"Elsevier BV","issue":"7","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T00:00:00Z","timestamp":1645574400000},"content-version":"vor","delay-in-days":387,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of the American College of Cardiology"],"published-print":{"date-parts":[[2021,2]]},"DOI":"10.1016\/j.jacc.2020.10.060","type":"journal-article","created":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T01:24:42Z","timestamp":1613438682000},"page":"902-921","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":382,"title":["Pathophysiology of Takotsubo Syndrome"],"prefix":"10.1016","volume":"77","author":[{"given":"Alexander R.","family":"Lyon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Citro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birke","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Morel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena R.","family":"Ghadri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Templin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmir","family":"Omerovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jacc.2020.10.060_bib1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/ejhf.424","article-title":"Current state of knowledge on Takotsubo syndrome: a position statement from the Taskforce on Takotsubo Syndrome of the Heart\u00a0Failure Association of the European Society of Cardiology","volume":"18","author":"Lyon","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.jacc.2020.10.060_bib2","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1093\/eurheartj\/ehy076","article-title":"International expert consensus document on Takotsubo syndrome (Part I): clinical characteristics, diagnostic criteria, and pathophysiology","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib3","doi-asserted-by":"crossref","first-page":"2823","DOI":"10.1093\/eurheartj\/ehv757","article-title":"Happy heart syndrome: role of positive emotional stress in takotsubo syndrome","volume":"37","author":"Ghadri","year":"2016","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib4","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1136\/heartjnl-2016-309783","article-title":"Takotsubo syndrome: aetiology, presentation and treatment","volume":"103","author":"Kato","year":"2017","journal-title":"Heart"},{"key":"10.1016\/j.jacc.2020.10.060_bib5","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1016\/j.jacc.2018.07.072","article-title":"Stress cardiomyopathy diagnosis and treatment: JACC state-of-the-art review","volume":"72","author":"Medina de Chazal","year":"2018","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib6","doi-asserted-by":"crossref","first-page":"2142","DOI":"10.1093\/eurheartj\/ehz170","article-title":"Cardiac arrest in takotsubo syndrome: results from the InterTAK Registry","volume":"40","author":"Gili","year":"2019","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib7","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1161\/CIRCULATIONAHA.118.036164","article-title":"Outcomes associated with cardiogenic shock in Takotsubo syndrome","volume":"139","author":"Di Vece","year":"2019","journal-title":"Circulation"},{"key":"10.1016\/j.jacc.2020.10.060_bib8","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1016\/j.jacc.2018.06.016","article-title":"Long-term prognosis of patients with Takotsubo syndrome","volume":"72","author":"Ghadri","year":"2018","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib9","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.ijcard.2015.03.162","article-title":"Mortality in takotsubo syndrome is similar to mortality in myocardial infarction \u2014 a report from the SWEDEHEART1 registry","volume":"185","author":"Redfors","year":"2015","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib10","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1093\/eurheartj\/ehy077","article-title":"International expert consensus document on Takotsubo syndrome (Part II): diagnostic workup, outcome, and management","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib11","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/eurheartj\/ehy462","article-title":"Fourth universal definition of myocardial infarction (2018)","volume":"40","author":"Thygesen","year":"2019","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib12","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.ijcard.2014.04.103","article-title":"Different catecholamines induce different patterns of takotsubo-like cardiac dysfunction in an apparently afterload dependent manner","volume":"174","author":"Redfors","year":"2014","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib13","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1038\/nrcardio.2015.39","article-title":"Epidemiology and pathophysiology of Takotsubo syndrome","volume":"12","author":"Akashi","year":"2015","journal-title":"Nat Rev Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib14","doi-asserted-by":"crossref","first-page":"2426","DOI":"10.1161\/CIRCULATIONAHA.116.027121","article-title":"Pathophysiology of Takotsubo syndrome","volume":"135","author":"Pelliccia","year":"2017","journal-title":"Circulation"},{"key":"10.1016\/j.jacc.2020.10.060_bib15","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.hfc.2012.12.010","article-title":"Takotsubo cardiomyopathy: the pathophysiology","volume":"9","author":"Tranter","year":"2013","journal-title":"Heart Fail Clin"},{"key":"10.1016\/j.jacc.2020.10.060_bib16","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.ijcard.2014.12.116","article-title":"Takotsubo cardiomyopathy, a new concept of cardiomyopathy: clinical features and pathophysiology","volume":"182","author":"Yoshikawa","year":"2015","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib17","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.nuclcard.2007.11.010","article-title":"Nuclear medicine imaging of takotsubo cardiomyopathy: typical form and midventricular ballooning syndrome","volume":"15","author":"Cimarelli","year":"2008","journal-title":"J\u00a0Nucl Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib18","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1093\/eurheartj\/ehl570","article-title":"Tako-Tsubo cardiomyopathy: intraindividual structural analysis in the acute phase and after functional recovery","volume":"28","author":"Nef","year":"2007","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib19","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1056\/NEJMoa043046","article-title":"Neurohumoral features of myocardial stunning due to sudden emotional stress","volume":"352","author":"Wittstein","year":"2005","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.jacc.2020.10.060_bib20","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.4158\/EP171930.OR","article-title":"Takotsubo-like cardiomyopathy in a large cohort of patients with pheochromocytoma and paraganglioma","volume":"23","author":"Gagnon","year":"2017","journal-title":"Endocr Pract"},{"key":"10.1016\/j.jacc.2020.10.060_bib21","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s10571-012-9804-8","article-title":"Stress cardiomyopathy: a syndrome of catecholamine-mediated myocardial stunning?","volume":"32","author":"Wittstein","year":"2012","journal-title":"Cell Mol Neurobiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib22","doi-asserted-by":"crossref","first-page":"858","DOI":"10.7326\/0003-4819-141-11-200412070-00010","article-title":"Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction","volume":"141","author":"Bybee","year":"2004","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jacc.2020.10.060_bib23","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1093\/eurjhf\/hfp076","article-title":"Activated cell survival cascade protects cardiomyocytes from cell death in Tako-Tsubo cardiomyopathy","volume":"11","author":"Nef","year":"2009","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.jacc.2020.10.060_bib24","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1093\/eurjhf\/hfs161","article-title":"A\u00a0mouse model reveals an important role for catecholamine-induced lipotoxicity in the pathogenesis of stress-induced cardiomyopathy","volume":"15","author":"Shao","year":"2013","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.jacc.2020.10.060_bib25","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.ijcard.2015.03.416","article-title":"Evidence of nitrosative stress within hearts of patients dying of Tako-tsubo cardiomyopathy","volume":"189","author":"Surikow","year":"2015","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib26","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1161\/CIRCULATIONAHA.112.111591","article-title":"High levels of circulating epinephrine trigger apical cardiodepression in a beta2-adrenergic receptor\/Gi-dependent manner: a new model of Takotsubo cardiomyopathy","volume":"126","author":"Paur","year":"2012","journal-title":"Circulation"},{"key":"10.1016\/j.jacc.2020.10.060_bib27","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1038\/hr.2009.28","article-title":"Effects of metoprolol on epinephrine-induced takotsubo-like left ventricular dysfunction in non-human primates","volume":"32","author":"Izumi","year":"2009","journal-title":"Hypertens Res"},{"key":"10.1016\/j.jacc.2020.10.060_bib28","doi-asserted-by":"crossref","first-page":"632","DOI":"10.2459\/JCM.0000000000000088","article-title":"Rat models reveal differences in cardiocirculatory profile between Takotsubo syndrome and acute myocardial infarction","volume":"16","author":"Redfors","year":"2015","journal-title":"J\u00a0Cardiovasc Med (Hagerstown)"},{"key":"10.1016\/j.jacc.2020.10.060_bib29","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1093\/ehjci\/jet079","article-title":"Contrast echocardiography reveals apparently normal coronary perfusion in a rat model of stress-induced (Takotsubo) cardiomyopathy","volume":"15","author":"Redfors","year":"2014","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"10.1016\/j.jacc.2020.10.060_bib30","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1253\/circj.72.106","article-title":"Local release of catecholamines from the hearts of patients with tako-tsubo-like left ventricular dysfunction","volume":"72","author":"Kume","year":"2008","journal-title":"Circ J"},{"key":"10.1016\/j.jacc.2020.10.060_bib31","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1111\/j.1540-8159.2008.02221.x","article-title":"Evolution of cardiac autonomic nervous activity indices in patients presenting with transient left ventricular apical ballooning","volume":"32","author":"Ortak","year":"2009","journal-title":"PACE"},{"key":"10.1016\/j.jacc.2020.10.060_bib32","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0093278","article-title":"Direct evidences for sympathetic hyperactivity and baroreflex impairment in Tako Tsubo cardiopathy","volume":"9","author":"Vaccaro","year":"2014","journal-title":"PLoS One"},{"key":"10.1016\/j.jacc.2020.10.060_bib33","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1159\/000338814","article-title":"Stress-induced cardiomyopathy in Sweden: evidence for different, ethnic predisposition and altered cardio-circulatory status","volume":"122","author":"Schultz","year":"2012","journal-title":"Cardiology"},{"key":"10.1016\/j.jacc.2020.10.060_bib34","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.nuclcard.2007.08.005","article-title":"Regional alterations in myocardial sympathetic innervation in patients with transient left-ventricular apical ballooning (Tako-Tsubo cardiomyopathy)","volume":"15","author":"Burgdorf","year":"2008","journal-title":"J\u00a0Nucl Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib35","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ijcard.2018.12.045","article-title":"Effects of pretreatment with cardiostimulants and beta-blockers on isoprenaline-induced takotsubo-like cardiac dysfunction in rats","volume":"281","author":"Ali","year":"2019","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib36","article-title":"Functional and histological assessment of an experimental model of Takotsubo's cardiomyopathy","volume":"3","author":"Sachdeva","year":"2014","journal-title":"J\u00a0Am Heart Assoc"},{"key":"10.1016\/j.jacc.2020.10.060_bib37","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1196\/annals.1410.079","article-title":"Catecholamines and estrogen are involved in the pathogenesis of emotional stress-induced acute heart attack","author":"Ueyama","year":"2008","journal-title":"Ann N Y Acad Sci"},{"key":"10.1016\/j.jacc.2020.10.060_bib38","doi-asserted-by":"crossref","DOI":"10.1111\/apha.12978","article-title":"Molecular pathways of oestrogen receptors and \u03b2-adrenergic receptors in cardiac cells: recognition of their similarities, interactions and therapeutic value","volume":"222","author":"Machuki","year":"2018","journal-title":"Acta Physiol (Oxf)"},{"key":"10.1016\/j.jacc.2020.10.060_bib39","first-page":"297","article-title":"Comparison of cardiac autonomic functions among postmenopausal women with and without hormone replacement therapy, and premenopausal women","volume":"55","author":"Gautam","year":"2011","journal-title":"Indian J Physiol Pharmacol"},{"key":"10.1016\/j.jacc.2020.10.060_bib40","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1002\/da.20341","article-title":"Sex differences in the use of coping strategies: predictors of anxiety and depressive symptoms","volume":"25","author":"Kelly","year":"2008","journal-title":"Depress Anxiety"},{"key":"10.1016\/j.jacc.2020.10.060_bib41","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1253\/circj.CJ-13-1276","article-title":"Evidence for brain activation in patients with takotsubo cardiomyopathy","volume":"78","author":"Suzuki","year":"2013","journal-title":"Circ J"},{"key":"10.1016\/j.jacc.2020.10.060_bib42","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.jacc.2017.12.022","article-title":"Takotsubo syndrome associated with structural brain alterations of the limbic system","volume":"71","author":"Hiestand","year":"2018","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib43","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1093\/eurheartj\/ehz068","article-title":"Altered limbic and autonomic processing supports brain-heart axis in Takotsubo syndrome","volume":"40","author":"Templin","year":"2019","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib44","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1093\/qjmed\/hcm028","article-title":"Cardiac autonomic imbalance in patients with reversible ventricular dysfunction takotsubo cardiomyopathy","volume":"100","author":"Akashi","year":"2007","journal-title":"QJM"},{"key":"10.1016\/j.jacc.2020.10.060_bib45","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.ijcard.2015.11.046","article-title":"Do we need MIBG in the evaluation of patients with suspected Takotsubo syndrome? Diagnostic, prognostic, and pathophysiologic connotations","volume":"203","author":"Madias","year":"2016","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib46","series-title":"Takotsubo-type cardiomyopathy due to multivessel spasm. Clinical Aspect of Myocardial Injury: From Ischemia to Heart\u00a0Failure","first-page":"56","author":"Sato","year":"1990"},{"key":"10.1016\/j.jacc.2020.10.060_bib47","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1016\/j.jacc.2010.03.107","article-title":"Endothelial function and vascular response to mental stress are impaired in patients with apical ballooning syndrome","volume":"56","author":"Martin","year":"2010","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib48","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/S0735-1097(02)02925-X","article-title":"Assessment of clinical features in transient left ventricular apical ballooning","volume":"41","author":"Abe","year":"2003","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib49","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/S0735-1097(02)02924-8","article-title":"Myocardial perfusion and fatty acid metabolism in patients with tako-tsubo-like left ventricular dysfunction","volume":"41","author":"Kurisu","year":"2003","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib50","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1161\/CIRCULATIONAHA.105.603050","article-title":"Evidence of a dominant backward-propagating \u201csuction\u201d wave responsible for diastolic coronary filling in humans, attenuated in left ventricular hypertrophy","volume":"113","author":"Davies","year":"2006","journal-title":"Circulation"},{"key":"10.1016\/j.jacc.2020.10.060_bib51","doi-asserted-by":"crossref","first-page":"2598","DOI":"10.1093\/eurheartj\/ehm401","article-title":"A\u00a0pathophysiologic study of tako-tsubo cardiomyopathy with F-18 fluorodeoxyglucose positron emission tomography","volume":"28","author":"Yoshida","year":"2007","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib52","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.ijcard.2014.01.052","article-title":"Are ischemic stunning, conditioning, and \u201ctakotsubo\u201d different sides to the same coin?","volume":"172","author":"Redfors","year":"2014","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib53","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.ijcard.2009.04.025","article-title":"Transient left ventricular dysfunction syndrome: patho-physiological bases through nuclear medicine imaging","volume":"144","author":"Cimarelli","year":"2010","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib54","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1093\/ehjci\/jet079","article-title":"Contrast echocardiography reveals apparently normal coronary perfusion in a rat model of stress-induced (Takotsubo) cardiomyopathy","volume":"15","author":"Redfors","year":"2014","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"10.1016\/j.jacc.2020.10.060_bib55","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1002\/clc.20747","article-title":"Takotsubo cardiomyopathy is not due to plaque rupture: an intravascular ultrasound study","volume":"33","author":"Haghi","year":"2010","journal-title":"Clin Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib56","doi-asserted-by":"crossref","first-page":"314","DOI":"10.5603\/CJ.2012.0055","article-title":"Left ventricular ballooning syndrome due to vasospasm of the middle portion of the left anterior descending coronary artery","volume":"19","author":"Fiol","year":"2012","journal-title":"Cardiol J"},{"key":"10.1016\/j.jacc.2020.10.060_bib57","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1093\/eurheartj\/eht392","article-title":"A\u00a0signature of circulating microRNAs differentiates takotsubo cardiomyopathy from acute myocardial infarction","volume":"35","author":"Jaguszewski","year":"2014","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib58","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/clc.20777","article-title":"Possible participation of endothelial cell apoptosis of coronary microvessels in the genesis of Takotsubo cardiomyopathy","volume":"33","author":"Uchida","year":"2010","journal-title":"Clin Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib59","doi-asserted-by":"crossref","first-page":"3007","DOI":"10.1093\/eurheartj\/ehp325","article-title":"Abnormal coronary reserve and left ventricular wall motion during cold pressor test in patients with previous left ventricular ballooning syndrome","volume":"30","author":"Barletta","year":"2009","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib60","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1007\/s003800300005","article-title":"Histological study on the distribution of autonomic nerves in the human heart","volume":"18","author":"Kawano","year":"2003","journal-title":"Heart Vessels"},{"key":"10.1016\/j.jacc.2020.10.060_bib61","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1007\/s10554-014-0453-5","article-title":"Cardiac Tc-99m sestamibi SPECT and F-18 FDG PET as viability markers in takotsubo cardiomyopathy","volume":"30","author":"Christensen","year":"2014","journal-title":"Int J Cardiovasc Imaging"},{"key":"10.1016\/j.jacc.2020.10.060_bib62","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1038\/ncpcardio1066","article-title":"Stress (Takotsubo) cardiomyopathy - a novel pathophysiological hypothesis to explain catecholamine-induced acute myocardial stunning","volume":"5","author":"Lyon","year":"2008","journal-title":"Nat Clin Pract Cardiovasc Med"},{"key":"10.1016\/j.jacc.2020.10.060_bib63","first-page":"192","article-title":"Increased responsiveness of left-ventricular apical myocardium to adrenergic stimuli","volume":"27","author":"Mori","year":"1993","journal-title":"CV Res"},{"key":"10.1016\/j.jacc.2020.10.060_bib64","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1016\/j.ijcard.2012.12.092","article-title":"Novel rat model reveals important roles of beta-adrenoreceptors in stress-induced cardiomyopathy","volume":"168","author":"Shao","year":"2013","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib65","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1007\/s00210-002-0681-4","article-title":"Cardiostimulant and cardiodepressant effects through overexpressed human b2-adrenoceptors in murine heart","volume":"367","author":"Heubach","year":"2003","journal-title":"Naunyn-Schmiedeberg's ArchPharmacol"},{"key":"10.1016\/j.jacc.2020.10.060_bib66","doi-asserted-by":"crossref","first-page":"H1487\u221296","DOI":"10.1152\/ajpheart.00443.2014","article-title":"Computational modeling of Takotsubo cardiomyopathy: effect of spatially varying beta-adrenergic stimulation in the rat left ventricle","volume":"307","author":"Land","year":"2014","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib67","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.celrep.2018.03.053","article-title":"Cardiomyocyte membrane structure and cAMP compartmentation produce anatomical variation in beta2AR-cAMP responsiveness in murine hearts","volume":"23","author":"Wright","year":"2018","journal-title":"Cell Rep"},{"key":"10.1016\/j.jacc.2020.10.060_bib68","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1124\/mol.65.5.1313","article-title":"Epinephrine activates both G(s) and G(i) pathways, but norepinephrine activates only the G(s) pathway through human beta(2)-adrenoceptors overexpressed in mouse heart","volume":"65","author":"Heubach","year":"2004","journal-title":"Mol Pharmacol"},{"key":"10.1016\/j.jacc.2020.10.060_bib69","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1074\/jbc.M705747200","article-title":"Norepinephrine- and epinephrine-induced distinct beta2-adrenoceptor signaling is dictated by GRK2 phosphorylation in cardiomyocytes","volume":"283","author":"Wang","year":"2008","journal-title":"J\u00a0Biol Chem"},{"key":"10.1016\/j.jacc.2020.10.060_bib70","article-title":"Incidence and clinical impact of recurrent Takotsubo syndrome: results from the GEIST Registry","volume":"8","author":"El-Battrawy","year":"2019","journal-title":"J\u00a0Am Heart Assoc"},{"key":"10.1016\/j.jacc.2020.10.060_bib71","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.jacc.2017.06.061","article-title":"Catecholamine-dependent beta-adrenergic signaling in a pluripotent stem cell model of Takotsubo cardiomyopathy","volume":"70","author":"Borchert","year":"2017","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib72","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.jacc.2017.07.716","article-title":"Stress in a dish: exploring the mechanisms of Takotsubo syndrome","volume":"70","author":"Lyon","year":"2017","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib73","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/s10557-013-6481-x","article-title":"Enhanced NO signaling in patients with Takotsubo cardiomyopathy: short-term pain, long-term gain?","volume":"27","author":"Nguyen","year":"2013","journal-title":"Cardiovasc Drugs Ther"},{"key":"10.1016\/j.jacc.2020.10.060_bib74","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1161\/CIRCULATIONAHA.117.031841","article-title":"Persistent long-term structural, functional, and metabolic changes after stress-induced (Takotsubo) cardiomyopathy","volume":"137","author":"Scally","year":"2018","journal-title":"Circulation"},{"key":"10.1016\/j.jacc.2020.10.060_bib75","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1093\/eurheartj\/ehp240","article-title":"Abnormalities in intracellular Ca2+ regulation contribute to the pathomechanism of Tako-Tsubo cardiomyopathy","volume":"30","author":"Nef","year":"2009","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib76","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/S0022-2828(85)80130-9","article-title":"Catecholamine cardiotoxicity","volume":"17","author":"Rona","year":"1985","journal-title":"J\u00a0Mol Cell Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib77","first-page":"31","article-title":"Isoproterenol induces in\u00a0vivo functional and metabolic abnormalities similar to those found in the infarcted rate heart","volume":"60","author":"Heather","year":"2009","journal-title":"J\u00a0Physiol Pharmacol"},{"key":"10.1016\/j.jacc.2020.10.060_bib78","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.ijcard.2007.05.119","article-title":"Sympathoadrenergic overstimulation in Tako-Tsubo cardiomyopathy triggered by physical and emotional stress","volume":"130","author":"Nef","year":"2008","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib79","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1093\/eurjhf\/hft040","article-title":"No association of G-protein-coupled receptor kinase 5 or beta-adrenergic receptor polymorphisms with Takotsubo cardiomyopathy in a large Australian cohort","volume":"15","author":"Figtree","year":"2013","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.jacc.2020.10.060_bib80","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s12881-018-0544-6","article-title":"Lack of genetic susceptibility in takotsubo cardiomyopathy: a case-control study","volume":"19","author":"Mattsson","year":"2018","journal-title":"BMC Med Genet"},{"key":"10.1016\/j.jacc.2020.10.060_bib81","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/eurjhf\/hfp173","article-title":"L41Q polymorphism of the G protein coupled receptor kinase 5 is associated with left ventricular apical ballooning syndrome","volume":"12","author":"Spinelli","year":"2010","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.jacc.2020.10.060_bib82","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1016\/j.ijcard.2013.03.050","article-title":"Polymorphisms of the antiapoptotic protein bag3 may play a role in the pathogenesis of tako-tsubo cardiomyopathy","volume":"168","author":"Citro","year":"2013","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib83","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ijcard.2018.12.045","article-title":"Effects of pretreatment with cardio-stimulants and beta-blockers on isoprenaline induced takotsubo-like dysfunction in rats","volume":"281","author":"Ali","year":"2019","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib84","doi-asserted-by":"crossref","first-page":"2651","DOI":"10.1093\/eurheartj\/ehn433","article-title":"Differential diagnosis of suspected apical ballooning syndrome using contrast-enhanced magnetic resonance imaging","volume":"29","author":"Eitel","year":"2008","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib85","first-page":"277","article-title":"Clinical characteristics and cardiovascular magnetic resonance findings in stress (takotsubo) cardiomyopathy","volume":"306","author":"Eitel","year":"2011","journal-title":"JAMA"},{"key":"10.1016\/j.jacc.2020.10.060_bib86","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1136\/heartjnl-2011-301481","article-title":"Slowly resolving global myocardial inflammation\/oedema in Tako-Tsubo cardiomyopathy: evidence from T2-weighted cardiac MRI","volume":"98","author":"Neil","year":"2012","journal-title":"Heart"},{"key":"10.1016\/j.jacc.2020.10.060_bib87","first-page":"766","article-title":"Characterization of the myocardial inflammatory response in acute stress-induced (Takotsubo) cardiomyopathy","volume":"3","author":"Wilson","year":"2018","journal-title":"J\u00a0Am Coll Cardiol Basic Trans Sci"},{"key":"10.1016\/j.jacc.2020.10.060_bib88","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1093\/europace\/euy147","article-title":"Atrial arrhythmias in Takotsubo cardiomyopathy: incidence, predictive factors, and prognosis","volume":"21","author":"Jesel","year":"2019","journal-title":"Europace"},{"key":"10.1016\/j.jacc.2020.10.060_bib89","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/j.hrthm.2018.04.002","article-title":"Ventricular arrhythmias and sudden cardiac arrest in Takotsubo cardiomyopathy: incidence, predictive factors, and clinical implications","volume":"15","author":"Jesel","year":"2018","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.jacc.2020.10.060_bib90","first-page":"369","article-title":"Ventricular arrhythmias in patients with Takotsubo syndrome","volume":"34","author":"Moller","year":"2018","journal-title":"J\u00a0Arrhythm"},{"key":"10.1016\/j.jacc.2020.10.060_bib91","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12968-017-0328-8","article-title":"Transient left atrial dysfunction is a feature of Takotsubo syndrome","volume":"19","author":"Stiermaier","year":"2017","journal-title":"J\u00a0Cardiovasc Magn Reson"},{"key":"10.1016\/j.jacc.2020.10.060_bib92","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/j.jelectrocard.2011.07.019","article-title":"Cardiac repolarization instability during psychological stress in patients with ventricular arrhythmias","volume":"44","author":"Abisse","year":"2011","journal-title":"J\u00a0Electrocardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib93","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.hrthm.2012.09.004","article-title":"Apicobasal gradient of left ventricular myocardial edema underlies transient T-wave inversion and QT interval prolongation (Wellens' ECG pattern) in Tako-Tsubo cardiomyopathy","volume":"10","author":"Perazzolo Marra","year":"2013","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.jacc.2020.10.060_bib94","doi-asserted-by":"crossref","first-page":"89","DOI":"10.4070\/kcj.2014.44.2.89","article-title":"Impact of pheochromocytoma on left ventricular hypertrophy and QTc prolongation: comparison with Takotsubo cardiomyopathy","volume":"44","author":"Choi","year":"2014","journal-title":"Korean Circ J"},{"key":"10.1016\/j.jacc.2020.10.060_bib95","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.ijcard.2017.11.007","article-title":"Estradiol protection against toxic effects of catecholamine on electrical properties in human-induced pluripotent stem cell derived cardiomyocytes","volume":"254","author":"El-Battrawy","year":"2018","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib96","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1136\/heartjnl-2016-311079","article-title":"Systemic inflammation as a novel QT-prolonging risk factor in patients with torsades de pointes","volume":"103","author":"Lazzerini","year":"2017","journal-title":"Heart"},{"key":"10.1016\/j.jacc.2020.10.060_bib97","first-page":"1717","article-title":"Systemic inflammation and arrhythmic risk: lessons from rheumatoid arthritis","volume":"38","author":"Lazzerini","year":"2017","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2020.10.060_bib98","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1002\/clc.23082","article-title":"Delayed ventricular pacing failure and correlations between pacing thresholds, left ventricular ejection fraction, and QTc values in a male with Takotsubo cardiomyopathy","volume":"41","author":"Brunetti","year":"2018","journal-title":"Clin Cardiol"},{"key":"10.1016\/j.jacc.2020.10.060_bib99","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.ejheart.2007.06.008","article-title":"Tako-Tsubo cardiomyopathy","volume":"9","author":"Brutsaert","year":"2007","journal-title":"Eur J Heart Fail"}],"container-title":["Journal of the American College of Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S073510972038133X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S073510972038133X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T13:38:57Z","timestamp":1760017137000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S073510972038133X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":99,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["S073510972038133X"],"URL":"https:\/\/doi.org\/10.1016\/j.jacc.2020.10.060","relation":{},"ISSN":["0735-1097"],"issn-type":[{"value":"0735-1097","type":"print"}],"subject":[],"published":{"date-parts":[[2021,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Pathophysiology of Takotsubo Syndrome","name":"articletitle","label":"Article Title"},{"value":"Journal of the American College of Cardiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacc.2020.10.060","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Published by Elsevier on behalf of the American College of Cardiology Foundation","name":"copyright","label":"Copyright"}]}}