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We greatly appreciate the comments offered by Dr Madias in response to our original article ‘Myocardial contrast imaging reveals apparently normal coronary perfusion in stress-induced (takotsubo) cardiomyopathy’.1 Dr Madias, in his letter, poses several important questions that would be worthwhile to address in our model. The first point raised is the presence of tissue oedema in affected myocardial segments in Takotsubo patients.2 The rat model is well suited to study the temporal changes in regional myocardial water content (i.e. oedema). We are currently investigating myocardial water content post-mortem in tissue samples harvested at different time-points after injection of isoproterenol. Our preliminary post-mortem data from tissue harvested 2h after isoproterenol show no significant difference in myocardial water content in apical tissue compared with basal tissue ( Figure 1 , n = 5, P = 0.5). Although one probably …

european heart journal. cardiovascular imaging

Normal apical myocardial perfusion in the rat model with Takotsubo syndrome: is subsequent microvascular dysfunction and hypoperfusion an epiphenomenon? Reply