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 journalArticlepeer-review


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
Publication statusPublished - Mar 15 2017


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

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine


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