Jabbour Jean Pierre, Arcari Luca, Cacciotti Luca, Magrì Damiano, Recchioni Tommaso, Valeri Livia, Maggio Enrico, Vizza Carmine Dario, Badagliacca Roberto, Papa Silvia
Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy.
Institute of Cardiology, Madre Giuseppina Vannini Hospital, Via di Acqua Bullicante, 4, 00177 Rome, Italy.
J Clin Med. 2024 Feb 19;13(4):1163. doi: 10.3390/jcm13041163.
In patients with prior Takotsubo syndrome (TTS), long-lasting functional cardiac limitations were described as compared with normal subjects. Emotion-triggered Takotsubo syndrome (E-TTS) has more favorable outcomes than TTS preceded by a physical trigger or by no identifiable factors. The aim of the present study was to assess long-term cardiac functional limitations in a cohort of asymptomatic E-TTS patients. We enrolled = 40 asymptomatic patients with a diagnosis of E-TTS. Cardiopulmonary exercise tests (CPET) were performed at 30 (12-40) months median follow-up from the acute event. A cohort of = 40 individuals matched for age, sex, body mass index and comorbidities served as control. Despite recovery of left ventricular ejection fraction, patients with prior E-TTS had lower peak VO and percentage of predicted peak VO (17.8 ± 3.6 vs. 22.1 ± 6.5; < 0.001 and 75.2 ± 14.1% vs. 100.6 ± 17.1%, < 0.001), VO at anaerobic threshold (AT) (11.5 [10.1-12.9] vs. 14.4 [12.5-18.7]; < 0.001), peak O pulse (9.8 ± 2.5 vs. 12.9 ± 3.5; < 0.001) and higher VE/VCO2 slope (30.5 ± 3.7 vs. 27.3 ± 3.5; < 0.001) compared with matched controls. We found no statistically significant differences in heart rate reserve (HRR), respiratory equivalent ratio (RER), mean blood pressure and peak PetCO between patients and controls. Despite its favorable outcome, patients with E-TTS in our population were found to have subclinical long-term functional cardiac limitations as compared with a control cohort.
与正常受试者相比，既往患有Takotsubo综合征（TTS）的患者存在长期的心脏功能受限情况。与由身体触发因素或无明确因素引发的TTS相比，情绪触发的Takotsubo综合征（E-TTS）的预后更有利。本研究的目的是评估一组无症状E-TTS患者的长期心脏功能受限情况。我们纳入了40例诊断为E-TTS的无症状患者。在急性事件发生后的中位随访30（12 - 40）个月时进行心肺运动试验（CPET）。选取40名年龄、性别、体重指数和合并症相匹配的个体作为对照组。尽管左心室射血分数已恢复，但既往患有E-TTS的患者与匹配的对照组相比，其峰值摄氧量（VO）和预测峰值VO百分比更低（17.8±3.6 vs. 22.1±6.5；P<0.001和75.2±14.1% vs. 100.6±17.1%，P<0.001），无氧阈（AT）时的VO（11.5[10.1 - 12.9] vs. 14.4[12.5 - 18.7]；P<0.001），峰值氧脉搏（9.8±2.5 vs. 12.9±3.5；P<0.001）以及更高的VE/VCO2斜率（30.5±3.7 vs. 27.3±3.5；P<0.001）。我们发现患者与对照组在心率储备（HRR）、呼吸当量比（RER）、平均血压和呼气末二氧化碳分压峰值（PetCO）方面无统计学显著差异。尽管E-TTS预后良好，但我们研究人群中的E-TTS患者与对照组相比仍存在亚临床长期心脏功能受限情况。
