open access

Vol 24, No 1 (2017)
Original articles — Clinical cardiology
Published online: 2017-01-02
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Left ventricular function after takotsubo is not fully recovered in long-term follow-up: A speckle tracking echocardiography study

Radoslaw Nowak, Marta Fijalkowska, Natasza Gilis-Malinowska, Milosz Jaguszewski, Rafal Galaska, Agnieszka Rojek, Krzysztof Narkiewicz, Marcin Gruchala, Marcin Fijalkowski
DOI: 10.5603/CJ.a2017.0001
·
Pubmed: 28070881
·
Cardiol J 2017;24(1):57-64.

open access

Vol 24, No 1 (2017)
Original articles — Clinical cardiology
Published online: 2017-01-02

Abstract

Background: Complete improvement of left ventricle (LV) systolic function is an essential feature of takotsubo cardiomyopathy (TTC). It is suggested that 2-dimensional speckle tracking echocardiography (2D STE) can evaluate LV dysfunction more accurately than conventional echocardiography. Thus, the purpose of this research was to assertain whether LV function recovery is complete after the acute phase of TTC using 2D STE commencing 6 to 9 months after discharge.

Methods: Thirty patients (29 females, 67 ± 11 years) with an apical ballooning TTC pattern 225.5 ± 27.4 days after their index event were enrolled. The control group consisted of 20 (19 females, 64  ± 9 years) age- and sex-matched volunteers without structural heart disease. Classic echocardiographic parameters, longitudinal strain and LV twist parameters were assessed and compared between the groups.

Results: There were no differences in traditional LV systolic, diastolic parameters and in global peak longitudinal strain. In comparison to controls, patients with TTC had lower mean apical rotation (14.4° ± 6.5° vs. 18.3° ± 6.7°; p = 0.048), slower mean peak early diastolic apical rotation rate (–85.1−°/s ± 40.9−°/s vs –119.4−°/s ± 41.9−°/s; p = 0.006) and higher pre-stretch index in the apex (2.16, IQR 0.33–5.50 vs. 0.00, IQR 0.00–2.95, p = 0.008).

Conclusions: The improvement of LV function in patients with TTC as assessed by 2D STE may not always be complete. Some residual abnormalities in LV apex function were observed in long-term recovery following TTC episodes.  

Abstract

Background: Complete improvement of left ventricle (LV) systolic function is an essential feature of takotsubo cardiomyopathy (TTC). It is suggested that 2-dimensional speckle tracking echocardiography (2D STE) can evaluate LV dysfunction more accurately than conventional echocardiography. Thus, the purpose of this research was to assertain whether LV function recovery is complete after the acute phase of TTC using 2D STE commencing 6 to 9 months after discharge.

Methods: Thirty patients (29 females, 67 ± 11 years) with an apical ballooning TTC pattern 225.5 ± 27.4 days after their index event were enrolled. The control group consisted of 20 (19 females, 64  ± 9 years) age- and sex-matched volunteers without structural heart disease. Classic echocardiographic parameters, longitudinal strain and LV twist parameters were assessed and compared between the groups.

Results: There were no differences in traditional LV systolic, diastolic parameters and in global peak longitudinal strain. In comparison to controls, patients with TTC had lower mean apical rotation (14.4° ± 6.5° vs. 18.3° ± 6.7°; p = 0.048), slower mean peak early diastolic apical rotation rate (–85.1−°/s ± 40.9−°/s vs –119.4−°/s ± 41.9−°/s; p = 0.006) and higher pre-stretch index in the apex (2.16, IQR 0.33–5.50 vs. 0.00, IQR 0.00–2.95, p = 0.008).

Conclusions: The improvement of LV function in patients with TTC as assessed by 2D STE may not always be complete. Some residual abnormalities in LV apex function were observed in long-term recovery following TTC episodes.  

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Keywords

takotsubo cardiomyopathy, echocardiography, 2-dimensional-speckle tracking echocardiography, rotation, left ventricular twist

About this article
Title

Left ventricular function after takotsubo is not fully recovered in long-term follow-up: A speckle tracking echocardiography study

Journal

Cardiology Journal

Issue

Vol 24, No 1 (2017)

Pages

57-64

Published online

2017-01-02

DOI

10.5603/CJ.a2017.0001

Pubmed

28070881

Bibliographic record

Cardiol J 2017;24(1):57-64.

Keywords

takotsubo cardiomyopathy
echocardiography
2-dimensional-speckle tracking echocardiography
rotation
left ventricular twist

Authors

Radoslaw Nowak
Marta Fijalkowska
Natasza Gilis-Malinowska
Milosz Jaguszewski
Rafal Galaska
Agnieszka Rojek
Krzysztof Narkiewicz
Marcin Gruchala
Marcin Fijalkowski

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