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Stress (Takotsubo) Cardiomyopathy -- A Novel Pathophysiological Hypothesis to Explain Catecholamine-induced Acute Myocardial Stunning : Clinical Testing


Clinical Testing

Our hypothesis is readily testable in animal models by use of genetic tools to manipulate the density of β-adrenoceptors and assessment of the ventricular response to catecholamines. Measurement of the gradient of the density of β2ARs in the human ventricle is more challenging. Direct measurement of the density of β2ARs in tissue specimens taken from different regions of the human ventricle would be ideal, but obtaining left ventricular biopsies from 'normal' human hearts raises major ethical concerns, and 'normal' donor hearts unsuitable for transplantation have frequently been exposed to high catecholamine levels before explantation. An alternative is in vivo measurement with PET and labeled receptor ligands.[61]In vivo or tissue measurements of β1AR:β2AR ratios in cardiomyocytes can also be confounded by β2ARs on the coronary vasculature[62] and on cardiac fibroblasts.[63]

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