title: Left ventricular function after takotsubo is not fully recovered in long-term follow-up: A speckle tracking echocardiography study.
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.
authors.affiliation: 1st Department of Cardiology, Medical University of Gdansk, Poland. nowakradek83@gmail.com.
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Nowak
authors.forename: Marta
authors.initials: M
authors.lastname: Fijalkowska
authors.forename: Natasza
authors.initials: N
authors.lastname: Gilis-Malinowska
authors.forename: Milosz
authors.initials: M
authors.lastname: Jaguszewski
authors.forename: Rafal
authors.initials: R
authors.lastname: Galaska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Rojek
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Marcin
authors.initials: M
authors.lastname: Gruchala
authors.forename: Marcin
authors.initials: M
authors.lastname: Fijalkowski
mesh_terms: D000368:Aged; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D011379:Prognosis; D020127:Recovery of Function; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: 2-dimensional-speckle tracking echocardiography; echocardiography; left ventricular twist; rotation; takotsubo cardiomyopathy