It was a pleasure to read the article by Kumar et al. reporting on the nonobstructive coronary artery disease (CAD) burden of patients with takotsubo syndrome (TTS) complicated with heart failure (HF). The authors employed an artificial intelligence algorithm to analyze 3-dimensional optical coherence tomography (OCT) findings from the left anterior descending coronary artery, to evaluate whether CAD plague morphological characteristics and functional assessment of the microvasculature (microcirculatory resistance deriving from the optic flow ratio) to evaluate their association, and their prognostic value for patients with TTS and HF. They found that their 10 patients with HF had an increased plaque volume, longer plaque lesion length, and increased percentage of lipidic and calcified plaques; also, they detected a correlation between the global plaque volume and microcirculatory resistance, which led them to conclude that morphological and functional information from OCT is associated with HF in patients presenting with TTS, and thus suggesting that underlying nonobstructive CAD may predict HF in such patients.