Local release of catecholamines from the hearts of patients with tako-tsubo-like left ventricular dysfunction.

BACKGROUND The precise mechanism of tako-tsubo-like left ventricular (LV) dysfunction remains unclear, although recent studies have shown that activation of sympathetic tone might be involved. However, local release of catecholamines from cardiac sympathetic efferent neurons in patients with tako-tsubo-like LV dysfunction remains poorly understood. The purpose of this study was to investigate evidence of local release of catecholamines from the hearts of patients with tako-tsubo-like LV dysfunction. METHODS AND RESULTS Five consecutive patients with tako-tsubo-like LV dysfunction were studied. After confirming LV apical ballooning and a normal coronary angiogram, sampling of blood for the measurement of plasma catecholamine levels was performed at the aortic root (Ao) and coronary sinus (CS). In all 5 cases, increased local release of norepinephrine from the heart was documented (597, 4,238, 2,121, 486, 371 pg/ml at the Ao; 836, 5,719, 3,386, 658, 472 pg/ml at the CS, respectively). CONCLUSIONS Increased cardiac catecholamines might cause the transient LV apical ballooning in patients with tako-tsubo-like LV dysfunction.