Stress-induced regional features of left ventricle is related to pathogenesis of clinical conditions with both acute and chronic stress

Tako-tsubo cardiomyopathy is a relatively newly described acute and reversible left ventricular (LV) dysfunction triggered by emotional stress. The disease is associated with excessive sympathetic stimulation, microvascular dysfunction and abnormal myocardial tissue metabolism. Recently, we have pointed out that tako-tsubo cardiomyopathy may be associated with particular LV features which are also described by quantitative echocardiographic methods in hypertensive heart disease. The patients with acute or chronic stress can be presented clinically by stress-induced LV hypercontractility of LV base, relevant LV outflow tract obstruction and narrowed cavity. Recent observations also have confirmed the possibility of association of both acute and chronic conditions in a clinical presentation of the patients. Therefore, we believe that the presence of both resistance and hypercontractile response of LV base to stress induction compared with midapical region in clinical conditions with acute or chronic stress is important in the disease process.