Abstract
In this issue, Hirano et al. addressed a novel hypothesis for the onset of takotsubo syndrome. The authors presented the two-step energy failure hypothesis. The first step is sudden stress increase in cardiac energy demands, following the additional supply from stored triglycerides. The second step is the prolonged stunning of the ventricle due to impaired uptake of energy substrates in the myocardium. They insisted that these steps might be one of the underlying mechanisms to develop this syndrome. To understand this mechanism would be helpful as a future option for the treatment and prevention of takotsubo syndrome.
