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To the Editor: Acute physical and psychological stress may provoke cardiovascular events, and although earthquake-associated increases in sudden death and acute myocardial infarction have been reported,^1-2 the effect of such conditions is unknown for stress-induced cardiomyopathy (Takotsubo cardiomyopathy).^3-4 On October 23, 2004, central Niigata, Japan, was shaken by a series of 3 strong earthquakes, with about 90 large aftershocks during the following week.

Methods

We retrospectively investigated the incidence of acute cardiovascular events, including Takotsubo cardiomyopathy, acute coronary syndrome, and sudden death, from September 25, 2004, to November 19, 2004, in 8 hospitals that treat most patients with such disorders in the area affected by the earthquake. These results were compared with the corresponding 8-week periods in 2003 and 2002. Event onset was defined as the time when symptoms first appeared. Takotsubo cardiomyopathy was diagnosed from characteristic transient apical dysfunction of the left ventricle by echocardiography, left ventriculography, or both, and . . . [Full Text of this Article]

Hiroshi Watanabe, MD, PhD
hiroshi7@med.niigata-u.ac.jp

Makoto Kodama, MD, PhD; Yuji Okura, MD, PhD; Yoshifusa Aizawa, MD, PhD
Division of Cardiology

Naohito Tanabe, MD, PhD
Division of Health Promotion

Masaomi Chinushi, MD, PhD
School of Health Sciences
Niigata University Graduate School of Medical and Dental Sciences
Niigata, Japan

Yuichi Nakamura, MD, PhD
Division of Cardiology
Nagaoka Chuo General Hospital

Tsuneo Nagai, MD, PhD
Division of Cardiology
Nagaoka Red Cross Hospital

Masahito Sato, MD, PhD; Masaaki Okabe, MD, PhD
Cardiovascular Center
Tachikawa General Hospital
Nagaoka, Japan

RELATED LETTERS

Earthquakes and Takotsubo Cardiomyopathy
Tomaso Gnecchi-Ruscone
JAMA. 2005;294(17):2169.
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Earthquakes and Takotsubo Cardiomyopathy—Reply
Hiroshi Watanabe, Makoto Kodama, Yoshifusa Aizawa, and Naohito Tanabe
JAMA. 2005;294(17):2169-2170.
EXTRACT | FULL TEXT