{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T11:04:07Z","timestamp":1771931047087,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T00:00:00Z","timestamp":1705708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Patients with takotsubo syndrome (TTS) may present coronary slow flow (CSF) in angiography performed in the acute myocardial infarction (MI). However, the detailed clinical relevance and its long-term impact remain poorly understood. Among 7771 MI patients hospitalized between 2012 and 2019, TTS was identified in 82 (1.1%) subjects. The epicardial blood flow was assessed with thrombolysis in myocardial infarction (TIMI) scale and corrected TIMI frame count (TFC), whereas myocardial perfusion with TIMI myocardial perfusion grade (TMPG). CSF was defined as TIMI-2 or corrected TFC &gt; 27 frames in at least one epicardial vessel. CSF was identified in 33 (40.2%) TTS patients. In the CSF-TTS versus normal-flow-TTS group, lower values of left ventricular ejection fraction on admission (33.5 (25\u201340) vs. 40 (35\u201345)%, p = 0.019), more frequent midventricular TTS (27.3 vs. 8.2%, p = 0.020) and the coexistence of both physical and emotional triggers (9.1 vs. 0%, p = 0.032) were noted. Within a median observation of 55 months, higher all-cause mortality was found in CSF-TTS compared with normal-flow TTS (30.3 vs. 10.2%, p = 0.024). CSF was identified as an independent predictor of long-term mortality (hazard ratio 10.09, 95% confidence interval 2.12\u201348.00, p = 0.004). CSF identified in two-fifths of TTS patients was associated with unfavorable long-term outcomes.<\/jats:p>","DOI":"10.3390\/ijms25021297","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T03:50:22Z","timestamp":1705895422000},"page":"1297","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Coronary Slow-Flow Phenomenon in Takotsubo Syndrome: The Prevalence, Clinical Determinants, and Long-Term Prognostic Impact"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5779-8434","authenticated-orcid":false,"given":"Konrad","family":"St\u0119pie\u0144","sequence":"first","affiliation":[{"name":"Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"},{"name":"Department of Thromboembolic Disorders, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2474-5512","authenticated-orcid":false,"given":"Karol","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"},{"name":"Department of Thromboembolic Disorders, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Karci\u0144ska","sequence":"additional","affiliation":[{"name":"Student Research Group at Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Horosin","sequence":"additional","affiliation":[{"name":"Student Research Group at Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7059-6207","authenticated-orcid":false,"given":"Alicia","family":"del Carmen Yika","sequence":"additional","affiliation":[{"name":"Student Research Group at Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Lenart","sequence":"additional","affiliation":[{"name":"Student Research Group at Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"G\u00f3rowska","sequence":"additional","affiliation":[{"name":"Student Research Group at Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0509-6075","authenticated-orcid":false,"given":"Sylwia","family":"Iwa\u0144czyk","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Poznan University of Medical Sciences, 61-848 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mateusz","family":"Podolec","sequence":"additional","affiliation":[{"name":"Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"},{"name":"Center for Innovative Medical Education, Jagiellonian University Medical College, 30-688 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7493-3626","authenticated-orcid":false,"given":"Aleksander","family":"Siniarski","sequence":"additional","affiliation":[{"name":"Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jadwiga","family":"Nessler","sequence":"additional","affiliation":[{"name":"Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaros\u0142aw","family":"Zalewski","sequence":"additional","affiliation":[{"name":"Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,20]]},"reference":[{"key":"ref_1","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":"Ma","year":"2018","journal-title":"J. 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