We thank the authors for the interest in our study recently published in the journal [1]. In that, we focused specifically on patients with takotsubo syndrome (TTS) and chronic obstructive pulmonary disease (COPD) [2], whereas Kato et al. analyzed patients affected by a large set of pulmonary pathologies [3]. This fact might have conditioned the partly discrepant results between the studies, though we agree that further larger research is needed to fully clarify this issue. To further address the stimulating comment, we analyzed outcomes of COPD patients in our population with or without acute pulmonary trigger and found them to be similar (Fig.
