Mechanistic study
Hemodynamic Assessment in Takotsubo Syndrome
- Mechanistic study
Authors' conclusion
TTS is characterized by reduced cardiac contractility, a shortened systolic period, inefficient energetics, and prolonged active relaxation but unaltered diastolic passive stiffness.
Study context
- Population
- Patients with Takotsubo syndrome undergoing left ventricular (LV) pressure-volume loop recording
- Participants
- 24 vs 20
- Comparison
- TTS vs controls without CVD
- TTSn = 24
- Controln = 20reference
Main finding
As reported in the abstract
LV hemodynamics by pressure-volume loops, TTS vs control
- End-systolic elastance 1.74 vs 2.35 mm Hg/mL (impaired LV contractility)
- P = 0.024
- Maximal rate of change in systolic pressure 1,533 vs 1,763 mm Hg/s
- P = 0.031
- End-systolic volume at 150 mm Hg 77.3 vs 46.4 mL
- P = 0.002
- Systolic period 286 vs 343 ms (shortened)
- P < 0.001
- Increased LV end-diastolic volume
- P = 0.031
- Increased LV end-systolic volume
- P < 0.001
- LV stroke volume preserved
- P = 0.370
- Lower LVEF
- P < 0.001
- Relaxation constant 69.5 vs 45.9 ms (prolonged active relaxation)
- P < 0.001
- Minimal rate of change in diastolic pressure −1,457 vs −2,192 mm Hg/s
- P < 0.001
- Diastolic stiffness not affected: end-diastolic volume at 15 mm Hg 96.7 vs 109.0 mL
- P = 0.942
- Mechanical efficiency significantly reduced
- P < 0.001
- Reduced stroke work
- P = 0.001
- Increased potential energy
- P = 0.036
- Similar total pressure-volume area
- P = 0.357
Original publication
Hemodynamic Assessment in Takotsubo Syndrome. J Am Coll Cardiol. Published 23 May 2023. doi:10.1016/j.jacc.2023.03.398
Summarised from the published abstract; every number is checked against it