Persistent Long-Term Structural, Functional, and Metabolic Changes After Stress-Induced (Takotsubo) Cardiomyopathy

• DOI: 10.1161/circulationaha.117.031841
• Publication Date: 2017-11-11T23:15:13Z
• Authors: Caroline Scally; Amelia Rudd; Alice Mezincescu; Heather Wilson; Janaki Srivanasan; Graham Horgan; Paul Broadhurst; David E. Newby; Anke Henning; Dana K. Dawson
• Keywords: Male; Time Factors; Supplementary Data; R Medicine; takotsubo; Ventricular Function, Left; 03 medical and health sciences; 0302 clinical medicine; Takotsubo Cardiomyopathy; Original Research Articles; Surveys and Questionnaires; cardiopulmonary exercise testing; Journal Article; Humans; Wellcome Trust; CGA-16-4 Catalytic Grant; Aged; Heart Failure; broken heart syndrome; Chief Scientist Office (CSO); R; WT103782AIA; Middle Aged; United States; 004; 3. Good health; Case-Control Studies; Disease Progression; Female; CH/09/002; stress-induced cardiomyopathy; Energy Metabolism; cardiac energetics; British Heart Foundation; Stress, Psychological; PG/15/108/31928

Takotsubo cardiomyopathy is an increasingly recognized acute heart failure syndrome precipitated by intense emotional stress. Although there apparent rapid and spontaneous recovery of left ventricular ejection fraction, the long-term clinical functional consequences takotsubo are ill-defined.In observational case-control study, we recruited 37 patients with prior (>12-month) cardiomyopathy, age-, sex-, comorbidity-matched control subjects. Patients completed Minnesota Living Heart Failure Questionnaire. All participants underwent detailed phenotypic characterization, including serum biomarker analysis, cardiopulmonary exercise testing, echocardiography, cardiac magnetic resonance 31P-spectroscopy.Participants were predominantly middle-age (64±11 years) women (97%). occurred 20 (range 13-39) months before majority (88%) had persisting symptoms compatible (median 13 [range 0-76] in Questionnaire) limitation on testing (reduced peak oxygen consumption, 24±1.3 versus 31±1.3 mL/kg/min, P<0.001; increased VE/Vco2 slope, 31±1 26±1, P=0.002). Despite normal fraction biomarkers, impaired deformation indices apical circumferential strain, -16±1.0 -23±1.5%, global longitudinal -17±1 -20±1%, P=0.006), native T1 mapping values (1264±10 1184±10 ms, P<0.001), energetic status (phosphocreatine/γ-adenosine triphosphate ratio, 1.3±0.1 1.9±0.1, P<0.001).In contrast to previous perceptions, has long-lasting consequences, demonstrable symptomatic impairment associated persistent subclinical dysfunction. Taken together our findings demonstrate that after develop a persistent, phenotype.URL: https://clinicaltrials.gov. Unique identifier: NCT02989454.