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Takotsubo syndrome (TTS) is a severe but reversible acute heart failure syndrome that occurs following high catecholaminergic stress. TTS patients are similar to those with acute coronary syndrome, with chest pain, dyspnoea and ST segment changes on electrocardiogram, but are characterised by apical akinesia of the left ventricle, with basal hyperkinesia in the absence of culprit coronary artery stenosis. The pathophysiology of TTS is not completely understood and there is a paucity of evidence to guide treatment. The mechanisms of TTS are thought to involve catecholaminergic myocardial stunning, microvascular dysfunction, increased inflammation and changes in cardiomyocyte metabolism. Here, we summarise the available literature to focus on the molecular basis for the pathophysiology of TTS to advance the understanding of the condition.

Original publication




Journal article


International journal of molecular sciences

Publication Date





Department of Cardiovascular Medicine, University of Oxford, Oxford OX1 2JD, UK.


Heart Ventricles, Humans, Electrocardiography, Arrhythmias, Cardiac, Acute Coronary Syndrome, Takotsubo Cardiomyopathy