TY - JOUR T1 - Response to: Correspondence on 'Outcomes of catecholamine and/or mechanical support in Takotsubo syndrome' by John E Madias JF - Heart JO - Heart SP - 986 LP - 987 DO - 10.1136/heartjnl-2022-320925 VL - 108 IS - 12 AU - Satoshi Terasaki AU - Koshiro Kanaoka AU - Yoshihiko Saito Y1 - 2022/06/01 UR - http://heart.bmj.com/content/108/12/986.2.abstract N2 - The Authors' reply In response to the valuable comments of John E Madias,1 we are pleased to share the results of the additional analysis on our recent study titled ‘Outcomes of catecholamine and/or mechanical support in Takotsubo syndrome’.2 We hope that the journal readership finds the additional information helpful.Although the exact pathophysiological mechanisms of Takotsubo syndrome (TTS) are not completely understood, considerable evidence suggests that sympathetic stimulation is crucial to its pathogenesis. It has previously been postulated that the prevalence of diabetes mellitus (DM) in patients with TTS is lower than that in the general population.3–5 The implication of this is that DM exerts a ‘protective effect’ against the development of TTS, a phenomenon … ER -