Reply to the letter by Ando et al.

摘要

We would like to thank Ando and coworkers for their interesting comment [1] on our paper entitled ?Takotsubo and Takotsubo-like syndrome: a common neurogenic myocardial stunning pathway?[2]. In our clinical experience, stress-induced cardiomyopathy detected by the specific scintigraphic signature associating severe 123I-MIBG and 18-FDG defects contrasting with normal 99mTc-Tetrofosmin perfusion could be assessed in a large variety of clinical settings, including the classical stress-induced catecholamine stunning (Takotsubo syndrome), epinephrine treatment or overdosing, trauma, acute medical or surgical illness including shock, intracranial bleeding and pheochro-mocytoma [3,4]. Other groups share similar experience, emotional cause being evidenced in a minority of cases, whereas physical stress owing to acute medical illness or surgical procedure now represents the vast majority of triggers. Whatever the triggering event might be, recent analysis clearly depicted a common pathophysiological underlying mechanism.