Autonomic function in Takotsubo syndrome long after the acute phase

Davide Lazzeroni, Matteo Bini, Paolo Castiglioni, Luca Moderato, Chiara Ciraci, Umberto Camaiora, Pietro Tito Ugolotti, Lorenzo Brambilla, Valerio Brambilla, Matteo Castrichini, Fabrizio Ugo, Nicola Gaibazzi, Paolo Coruzzi

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 β-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.

Original languageEnglish
Pages (from-to)222-224
Number of pages3
JournalInternational Journal of Cardiology
Volume231
DOIs
Publication statusPublished - Mar 15 2017

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Takotsubo Cardiomyopathy
Healthy Volunteers
Myocardial Infarction
Heart Rate
Exercise Test
Exercise

Keywords

  • Autonomic nervous system
  • Exercise stress test
  • Heart rate recovery
  • Myocardial infarction
  • Takotsubo syndrome

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

Autonomic function in Takotsubo syndrome long after the acute phase. / Lazzeroni, Davide; Bini, Matteo; Castiglioni, Paolo; Moderato, Luca; Ciraci, Chiara; Camaiora, Umberto; Ugolotti, Pietro Tito; Brambilla, Lorenzo; Brambilla, Valerio; Castrichini, Matteo; Ugo, Fabrizio; Gaibazzi, Nicola; Coruzzi, Paolo.

In: International Journal of Cardiology, Vol. 231, 15.03.2017, p. 222-224.

Research output: Contribution to journalArticle

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 2017, 'Autonomic function in Takotsubo syndrome long after the acute phase', International Journal of Cardiology, vol. 231, pp. 222-224. https://doi.org/10.1016/j.ijcard.2017.01.002
Lazzeroni, Davide ; Bini, Matteo ; Castiglioni, Paolo ; Moderato, Luca ; Ciraci, Chiara ; Camaiora, Umberto ; Ugolotti, Pietro Tito ; Brambilla, Lorenzo ; Brambilla, Valerio ; Castrichini, Matteo ; Ugo, Fabrizio ; Gaibazzi, Nicola ; Coruzzi, Paolo. / Autonomic function in Takotsubo syndrome long after the acute phase. In: International Journal of Cardiology. 2017 ; Vol. 231. pp. 222-224.
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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 β-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.",
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AU - Lazzeroni, Davide

AU - Bini, Matteo

AU - Castiglioni, Paolo

AU - Moderato, Luca

AU - Ciraci, Chiara

AU - Camaiora, Umberto

AU - Ugolotti, Pietro Tito

AU - Brambilla, Lorenzo

AU - Brambilla, Valerio

AU - Castrichini, Matteo

AU - Ugo, Fabrizio

AU - Gaibazzi, Nicola

AU - Coruzzi, Paolo

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N2 - 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 β-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.

AB - 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 β-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.

KW - Autonomic nervous system

KW - Exercise stress test

KW - Heart rate recovery

KW - Myocardial infarction

KW - Takotsubo syndrome

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