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Response by Jung et al to Letter Regarding Article, "Takotsubo-Like Myocardial Dysfunction in Ischemic Stroke: A Hospital-Based Registry and Systematic Literature Review".

We appreciate the interest and comments from Nagai et al regarding our article, “Takotsubo-Like Myocardial Dysfunction in Ischemic Stroke: A Hospital-Based Registry and Systematic Literature Review.”1

The pathomechanism of Takotsubo syndrome (TS) is poorly understood. Among several possible mechanisms, cardiovascular system changes caused by insular cortex damage and subsequent sympathetic overactivity have been proposed to mediate stroke-related TS.2

In our study, stroke preceded Takotsubo-like myocardial dysfunction in 11 patients and was assumed to precede Takotsubo-like myocardial dysfunction in 10 patients. Of 21 patients in total, 11 patients (52.4%) had insular …