{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T08:04:08Z","timestamp":1770710648084,"version":"3.49.0"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Youth Fund Project of The First Hospital of Tsinghua University","award":["2023-QN-03"],"award-info":[{"award-number":["2023-QN-03"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Takotsubo cardiomyopathy (TTC) complicated by sinus arrest and third-degree atrioventricular block (AVB) is extremely rare. This case illustrates the utility of 18F-FDG PET\/CT (fluorodeoxyglucose positron emission tomography\/computed tomography) in characterizing myocardial stunning of TTC with dual nodal dysfunction and provides insights into long-term conduction outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 77-year-old female presented with acute chest pain and palpitations due to emotional stress. Echocardiography showed left ventricular (LV) apical hypokinesis [global longitudinal strain (GLS) \u221214.8%], coronary computed tomography angiography revealed mild mid-left anterior descending artery stenosis, and cardiac biomarkers were elevated (troponin-T: 0.0803\u2005ng\/mL; N-terminal pro-B-type natriuretic peptide: 696.92\u2005ng\/L). Holter monitoring documented sinus arrest, third-degree AVB, and a minimum heart rate of 31\u2005b.p.m. Fluorodeoxyglucose positron emission tomography\/computed tomography showed increased glucose uptake in the LV apex (consistent with myocardial stunning\/inflammation), while technetium-99m methoxyisobutylisonitrile SPECT\/CT detected mild apical hypoperfusion. A dual-chamber pacemaker was implanted for refractory bradycardia. At 1-month follow-up, LV apical hypokinesis resolved (GLS \u221219.0%), with recovered AV nodal but persistent sinoatrial nodal dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Fluorodeoxyglucose positron emission tomography\/computed tomography is valuable for clarifying the metabolic basis of TTC-related myocardial dysfunction, complementing perfusion imaging. Early pacing evaluation is critical for TTC patients with sinoatrial nodal impairment\u2014even with AV nodal recovery, persistent sinoatrial dysfunction may require long-term pacing support to prevent bradycardia-related adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag058","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T12:37:50Z","timestamp":1769171870000},"source":"Crossref","is-referenced-by-count":0,"title":["Fluorodeoxyglucose positron emission tomography\/computed tomography in Takotsubo cardiomyopathy complicated by sinus arrest and third-degree atrioventricular block: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1070-1279","authenticated-orcid":false,"given":"Ming","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Cardiology, The First Hospital of Tsinghua University , Jiuxianqiao 1st Neighborhood No. 6, Chaoyang District, Beijing 100016 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, The First Hospital of Tsinghua University \u00a0 Jiuxianqiao 1st Neighborhood No. 6, Chaoyang District, Beijing 100016 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunbo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, The First Hospital of Tsinghua University \u00a0 Jiuxianqiao 1st Neighborhood No. 6, Chaoyang District, Beijing 100016 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongliang","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Hospital of Tsinghua University , Jiuxianqiao 1st Neighborhood No. 6, Chaoyang District, Beijing 100016 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"2026020907464980200_ytag058-B1","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1016\/j.jacc.2020.10.060","article-title":"Pathophysiology of Takotsubo syndrome: JACC state-of-the-art review","volume":"77","author":"Lyon","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026020907464980200_ytag058-B2","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1016\/j.hlc.2022.03.010","article-title":"Arrhythmias and their electrophysiological mechanisms in Takotsubo syndrome: a narrative review","volume":"31","author":"Koh","year":"2022","journal-title":"Heart Lung Circ"},{"key":"2026020907464980200_ytag058-B3","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1007\/s11886-024-02139-x","article-title":"Diagnosing non-ischemic cardiomyopathies on myocardial perfusion imaging with positron emission tomography","volume":"26","author":"Jakulla","year":"2024","journal-title":"Curr Cardiol Rep"},{"key":"2026020907464980200_ytag058-B4","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1007\/s12350-016-0775-x","article-title":"Takotsubo cardiomyopathy: FDG myocardial uptake pattern in fasting patients. Comparison of PET\/CT, SPECT, and ECHO results","volume":"25","author":"Kobylecka","year":"2018","journal-title":"J Nucl Cardiol"},{"key":"2026020907464980200_ytag058-B5","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1016\/j.hrthm.2016.06.013","article-title":"Management of arrhythmias in patients with Takotsubo cardiomyopathy: is the implantation of permanent devices necessary?","volume":"13","author":"Stiermaier","year":"2016","journal-title":"Heart Rhythm"},{"key":"2026020907464980200_ytag058-B6","first-page":"e2743","article-title":"Takotsubo cardiomyopathy presenting with sinoatrial disease: a rare presentation","volume":"10","author":"Sabzwari","year":"2018","journal-title":"Cureus"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytag058\/66592385\/ytag058.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/2\/ytag058\/66592385\/ytag058.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/2\/ytag058\/66592385\/ytag058.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T12:47:02Z","timestamp":1770641222000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag058\/8442466"}},"subtitle":[],"editor":[{"given":"Doralisa","family":"Morrone","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Akira","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Marco","family":"Tomasino","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Deepty","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,27]]},"references-count":6,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag058","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2026,1,27]]},"article-number":"ytag058"}}