title: Diastolic function improves after resolution of takotsubo cardiomyopathy.
abstract: BACKGROUND
  Takotsubo cardiomyopathy (TTC) is a condition of reversible left ventricular (LV) systolic dysfunction. However, the diastolic function (DF) manifestations of TTC have not been widely investigated. We performed a bicentric study with retrospective analysis of DF in patients with TTC, during onset and at follow-up.
  
  
  METHODS
  Twenty-eight patients with TTC (64 ± 10 years, F 24) were included. All underwent echocardiograms acutely and at the recovery phase (average three months later). Diastolic and systolic function parameters were recorded, including E-wave velocity (E), A-wave velocity, E/A ratio, relaxation (e') and contractility (S') based on tissue Doppler velocities of the mitral annuli, ejection fraction (EF), left atrial (LA) size and DF stages.
  
  
  RESULTS
  Recovery, including the mean difference with 95% confidence interval, was associated with tending improvement (i.e. uncorrected significance) in E [13 cm s(-1) (-24, -2·3), P = 0·02] and in E/A ratio [0·2 (-0·41, -0·02), P = 0·04], as well as significant improvement (after multiple comparison correction) in mean e' [2·0 cm s(-1) (-3·3, -1·2), P<0·001] and in A-wave duration [29 ms (-46·7, -12·7), P = 0·002]. LA area tended to decrease during recovery [-2 cm² (0·33, 2·4), P = 0·01]. Improvement in DF stages was significant between the phases (21% versus 58% defined as normal DF, P = 0·016). Improvement in LVEF correlated with improvement in mean e' (r = 0·52, P = 0·02).
  
  
  CONCLUSIONS
  TTC is associated with an acute impairment of conventional DF variables, which improves during recovery. DF recovery seems to occur in parallel with systolic recovery in patients with TTC.
authors.affiliation: SUNY Downstate Medical Center, Brooklyn, NY, USA.|Marshfield clinic-weston center, Weston, WI, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Örebro University Hospital, Örebro, Sweden.
authors.forename: Micael
authors.initials: M
authors.lastname: Waldenborg
authors.affiliation: New York Methodist Hospital, Brooklyn, NY, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Bhumireddy
authors.affiliation: SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Keshwar
authors.initials: K
authors.lastname: Ramkissoon
authors.affiliation: Örebro University Hospital, Örebro, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Loiske
authors.affiliation: SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Antony L
authors.initials: AL
authors.lastname: Innasimuthu
authors.affiliation: SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Grodman
authors.affiliation: New York Methodist Hospital, Brooklyn, NY, USA.
authors.forename: John F
authors.initials: JF
authors.lastname: Heitner
authors.affiliation: Örebro University Hospital, Örebro, Sweden.
authors.forename: Kent
authors.initials: K
authors.lastname: Emilsson
authors.affiliation: SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Lazar
mesh_terms: D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000517:prevention & control*
keywords: broken heart syndrome; doppler; echocardiography; relaxation; stress-induced cardiomyopathy