Vulnerability to Sympathetic Stress Does Not Persist in Takotsubo Stress Cardiomyopathy

- We studied dobutamine stress echocardiography in takotsubo stress cardiomyopathy and control subjects.
- At rest takotsubo patients had a significantly higher left ventricular myocardial performance index.
- No difference between takotsubo stress cardiomyopathy and control subjects during stress.
- Vulnerability to sympathetic stimulation does not persist in takotsubo stress cardiomyopathy.

ObjectiveOur objective was to investigate whether dobutamine stress echocardiography (DSE) could induce abnormal cardiac function in takotsubo stress cardiomyopathy (TSC) patients in a stable condition after the acute attack.Methods and ResultsThis was a case-control study and a substudy of the Stockholm Myocardial Infarction With Normal Coronaries (SMINC) study. Twenty-two patients with a previous episode of TSC and 22 sex- and age-matched control subjects were recruited from the SMINC study and investigated with the use of DSE. All TSC patients had a previous normal cardiovascular magnetic resonance investigation. Tissue Doppler imaging-derived time phases of the cardiac cycle were recorded to calculate myocardial performance index (MPI) to assess ventricular function. Compared with control subjects at rest, TSC patients had a slightly but significantly higher left ventricular MPI (LV-MPI; 0.53 vs 0.59; P = .01) and as a trend higher right ventricular MPI (0.38 vs 0.47; P = .08), although during DSE these variables did not differ significantly.ConclusionWe found no difference in standard diastolic parameters between TSC and control subjects, but a significant higher value in LV-MPI in the TSC group at rest. However, no such difference could be demonstrated during DSE between the groups, indicating that vulnerability to sympathetic stimulation does not persist in TSC patients.