Objectives: Although it is well documented that an exaggerated sympathetic stimulation plays a role in the development of Takotsubo Syndrome (TS) during the acute phase, only few studies have focused on autonomic adaptations in stress-induced cardiomyopathy long after the acute phase. Aim of the study was to investigate whether an impairment of the autonomic function is still present long after a TS event. This was done by comparing the response to a maximal exercise test in TS patients after apparent recovery (> 1-year after the acute event) with that obtained in healthy subjects and in post-myocardial infarction (post-MI) patients. Methods: To assess heart rate recovery (HRR) and chronotropic response (CR), 24 TS patients, 25 healthy subjects and 22 post-MI patients underwent maximal exercise test, after at least 3 days of beta-blockers wash-out. Results: HRR in TS patients (19.2 +/- 9.7 bpm) was lower than in healthy subjects (27.7 +/- 8.3, p = 0.003), and similar to post-MI patients (19.3 +/- 8.4; p = 0.99). A decreasing CR trend (p = 0.06), higher in healthy subjects (72 +/- 13%) than in TS (65 +/- 22%) and post-MI (57 +/- 21%) patients, was also found. Conclusion: Compared to healthy subjects, TS patients showed a blunted parasympathetic reactivation after exercise, similar to that observed in post-MI patients, thereby suggesting that vagal control of heart rate after exercise is abnormal long after the acute presentation of TS. (C) 2017 Elsevier Ireland Ltd. All rights reserved.

Autonomic function in Takotsubo syndrome long after the acute phase

Castiglioni P;
2017-01-01

Abstract

Objectives: Although it is well documented that an exaggerated sympathetic stimulation plays a role in the development of Takotsubo Syndrome (TS) during the acute phase, only few studies have focused on autonomic adaptations in stress-induced cardiomyopathy long after the acute phase. Aim of the study was to investigate whether an impairment of the autonomic function is still present long after a TS event. This was done by comparing the response to a maximal exercise test in TS patients after apparent recovery (> 1-year after the acute event) with that obtained in healthy subjects and in post-myocardial infarction (post-MI) patients. Methods: To assess heart rate recovery (HRR) and chronotropic response (CR), 24 TS patients, 25 healthy subjects and 22 post-MI patients underwent maximal exercise test, after at least 3 days of beta-blockers wash-out. Results: HRR in TS patients (19.2 +/- 9.7 bpm) was lower than in healthy subjects (27.7 +/- 8.3, p = 0.003), and similar to post-MI patients (19.3 +/- 8.4; p = 0.99). A decreasing CR trend (p = 0.06), higher in healthy subjects (72 +/- 13%) than in TS (65 +/- 22%) and post-MI (57 +/- 21%) patients, was also found. Conclusion: Compared to healthy subjects, TS patients showed a blunted parasympathetic reactivation after exercise, similar to that observed in post-MI patients, thereby suggesting that vagal control of heart rate after exercise is abnormal long after the acute presentation of TS. (C) 2017 Elsevier Ireland Ltd. All rights reserved.
2017
Lazzeroni, D; Bini, M; Castiglioni, P; Moderato, L; Ciraci, C; Camaiora, U; Ugolotti, Pt; Brambilla, L; Brambilla, V; Castrichini, M; Ugo, F; Gaibazzi, N; Coruzzi, P
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2145146
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