Key result
Coronary artery tortuosity severity shows no link to peak troponin or LVEF in Takotsubo syndrome.
Why the study?
Coronary artery tortuosity is often considered benign, but emerging evidence suggests potential hemodynamic significance in non-atherosclerotic cardiomyopathies like Takotsubo syndrome.
Does coronary artery tortuosity severity correlate with myocardial injury or ventricular recovery in patients with Takotsubo syndrome?
Observational (n=100)
Yes
Does coronary artery tortuosity severity correlate with myocardial injury or ventricular recovery in patients with Takotsubo syndrome?
p-value: p=0.588 (troponin), 0.820 (EF)
Coronary artery tortuosity is highly prevalent in Takotsubo syndrome, but its severity does not correlate with myocardial injury or ventricular function recovery.
Background Coronary artery tortuosity (CAT) is often viewed as a benign angiographic finding; however, emerging evidence suggests its potential hemodynamic significance, particularly in non-atherosclerotic cardiomyopathies such as Takotsubo syndrome (TS). This study aimed to investigate the prevalence and hemodynamic implications of CAT in patients diagnosed with Takotsubo cardiomyopathy (TCM) and to evaluate the association between the severity of tortuosity and myocardial injury markers, recovery of ventricular function, and other clinical variables. Methods A retrospective review of 100 patients with Takotsubo cardiomyopathy (TCM) from the Baptist Memorial Hospital network (2015–2025) was conducted. Coronary artery tortuosity severity was quantified using angiographic criteria based on the number and degree of vessel curvatures in major epicardial arteries. Associations between coronary artery tortuosity and biochemical or echocardiographic parameters were evaluated using multiple linear regression and non-parametric tests. Results CAT was highly prevalent (85.1%) in this TCM cohort, with a mean tortuosity index of 3.26-significantly higher than in general angiography populations. No significant correlations were found between tortuosity severity and peak troponin levels (P = 0.588) or ejection fraction (EF) at presentation (P = 0.820). Full EF recovery (55–65%) at ≥ 3 months occurred in 70.7% of patients and was not significantly associated with prior cardiomyopathy, coronary artery tortuosity index or baseline troponin levels. Conclusion Coronary artery tortuosity was highly prevalent in this cohort of patients with Takotsubo syndrome. However, tortuosity severity was not associated with markers of myocardial injury or recovery of ventricular function. These findings suggest that coronary tortuosity may represent a vascular phenotype frequently observed in Takotsubo syndrome, although its direct pathophysiologic role remains uncertain.
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Arthur et al. (2026) conducted an observational in Takotsubo syndrome (n=100). Coronary artery tortuosity was evaluated on Correlation between tortuosity severity and peak troponin levels or ejection fraction at presentation (p=0.588 (troponin), 0.820 (EF)). Coronary artery tortuosity was highly prevalent (85.1%) in Takotsubo syndrome, but its severity was not significantly associated with peak troponin levels (P=0.588) or ejection fraction (P=0.820).
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