{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:37:48Z","timestamp":1777855068046,"version":"3.51.4"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The honeycomb-like structure is an uncommon cause of myocardial ischaemia, detectable through high-resolution intracoronary imaging. Although percutaneous coronary intervention (PCI) for honeycomb-like structure has shown favourable outcomes, the relationship between PCI for honeycomb-like structure and subsequent improvement in cardiac function remains poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 58-year-old male was referred to our hospital for exertional dyspnoea. He was diagnosed with heart failure, and echocardiography revealed a reduced left ventricular ejection fraction (LVEF) of 24%, with particularly severe hypokinesis observed in the left anterior descending artery (LAD) territory. Cardiac magnetic resonance imaging showed non-transmural late gadolinium enhancement predominantly in the endocardial layer of the anterior LV wall. Coronary angiography demonstrated diffuse moderate stenosis in the LAD, with fractional flow reserve (FFR) of 0.29, and optical coherence tomography revealed a honeycomb-like structure. Two everolimus-eluting stents were implanted in the LAD. Following the PCI, significant recovery of LV wall motion including the anterior and apical segments was observed, with LVEF increasing from 24% to 46%. The 1-year follow-up showed no worsening of heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This is the first documentation of an ischaemic cardiomyopathy showing significant recovery of cardiac function after PCI targeting honeycomb-like structure. As reported in previous studies focusing on honeycomb-like structure, this case also exhibited angiographic underestimation of stenosis and low FFR value reflecting the true haemodynamic severity. The pathogenesis of honeycomb-like structure\u2014thrombus formation and spontaneous recanalization\u2014may have triggered ischaemic preconditioning, resulting in the development of hibernating myocardium, which could explain the viable myocardium in this case.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag265","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T11:21:25Z","timestamp":1776079285000},"source":"Crossref","is-referenced-by-count":0,"title":["Ischaemic cardiomyopathy with a significant improvement in left ventricular wall motion following revascularization for a honeycomb-like structure of the left anterior descending artery: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2144-3162","authenticated-orcid":false,"given":"Hiroshi","family":"Yoshikawa","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hiratsuka Kyosai Hospital , 9-11 Oiwake, Hiratsuka, Kanagawa 254-8502 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Hanyu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Hospital Organization Disaster Medical Center , 3256 Midoricho, Tachikawa, Tokyo 190-0014 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hiratsuka Kyosai Hospital , 9-11 Oiwake, Hiratsuka, Kanagawa 254-8502 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taishi","family":"Yonetsu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Institute of Science Tokyo , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3582-6104","authenticated-orcid":false,"given":"Tetsuo","family":"Sasano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Institute of Science Tokyo , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"2026042919185135700_ytag265-B1","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.jcmg.2012.03.012","article-title":"OCT findings in patients with recanalization of organized thrombi in coronary arteries","volume":"5","author":"Kang","year":"2012","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026042919185135700_ytag265-B2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjcr\/ytaa250","article-title":"Honeycomb-like structure in spontaneous recanalized coronary thrombus demonstrated by serial angiograms: a case report","volume":"4","author":"Kahata","year":"2020","journal-title":"Eur Heart J Case Rep"},{"key":"2026042919185135700_ytag265-B3","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s12928-022-00878-8","article-title":"Pathological findings of honeycomb-like structure resected by directional coronary atherectomy","volume":"38","author":"Numasawa","year":"2023","journal-title":"Cardiovasc Interv Ther"},{"key":"2026042919185135700_ytag265-B4","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1016\/j.jcin.2012.01.024","article-title":"A honeycomb-like structure in the left anterior descending coronary artery: demonstration of recanalized thrombus by optical coherence tomography","volume":"5","author":"Toutouzas","year":"2012","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042919185135700_ytag265-B5","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1253\/circj.CJ-17-0810","article-title":"Diagnosis and management of spontaneously recanalized coronary thrombus guided by optical coherence tomography - lessons from the French \u201cLotus Root\u201d registry","volume":"82","author":"Souteyrand","year":"2018","journal-title":"Circ J"},{"key":"2026042919185135700_ytag265-B6","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s12928-015-0325-5","article-title":"Novel physiological insight into a lotus root appearance in stable coronary artery diseases; report of two cases","volume":"31","author":"Suzuki","year":"2016","journal-title":"Cardiovasc Interv Ther"},{"key":"2026042919185135700_ytag265-B7","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/MCA.0000000000000822","article-title":"Anatomical features and clinical outcome of a honeycomb-like structure in the coronary artery: reports from 16 consecutive patients","volume":"31","author":"Xu","year":"2020","journal-title":"Coron Artery Dis"},{"key":"2026042919185135700_ytag265-B8","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1093\/eurheartj\/14.suppl_A.22","article-title":"The hibernating myocardium in ischaemia and congestive heart failure","volume":"14","author":"Rahimtoola","year":"1993","journal-title":"Eur Heart J"},{"key":"2026042919185135700_ytag265-B9","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1093\/eurheartj\/eht018","article-title":"The hibernating myocardium: current concepts, diagnostic dilemmas, and clinical challenges in the post-STICH era","volume":"34","author":"Shah","year":"2013","journal-title":"Eur Heart J"},{"key":"2026042919185135700_ytag265-B10","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1161\/01.CIR.74.5.1124","article-title":"Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium","volume":"74","author":"Murry","year":"1986","journal-title":"Circulation"},{"key":"2026042919185135700_ytag265-B11","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1056\/NEJMoa2206606","article-title":"Percutaneous revascularization for ischemic left ventricular dysfunction","volume":"387","author":"Perera","year":"2022","journal-title":"N Engl J Med"},{"key":"2026042919185135700_ytag265-B12","article-title":"Ejection fraction improvement following contemporary high-risk percutaneous coronary intervention: RESTORE EF study results","volume":"1","author":"Wollmuth","year":"2022","journal-title":"J Soc Cardiovasc Angiogr Interv"}],"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\/ytag265\/68088894\/ytag265.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/4\/ytag265\/68088894\/ytag265.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/4\/ytag265\/68088894\/ytag265.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:18:58Z","timestamp":1777504738000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag265\/8654683"}},"subtitle":[],"editor":[{"given":"Grigoris","family":"Karamasis","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Chang Hoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Antonios","family":"Karanasos","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag265","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,4,1]]},"article-number":"ytag265"}}