{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T08:26:46Z","timestamp":1774427206646,"version":"3.50.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\u2003<\/jats:title><jats:p>Takotsubo syndrome (TTS) is usually associated with rapid and spontaneous recovery of left ventricular (LV) function. However, a proportion of patients may have persistent symptoms. This study aimed to determine the haemodynamic and LV contractile responses to exercise in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Thirty symptomatic TTS patients referred for exercise echocardiography, a median of 15\u2009months following the index TTS episode, were matched with 30 controls with normal exercise echocardiography. Beta-blockers were withheld prior to the test. LV volumes, ejection fraction (EF) and wall motion score index (WMSI), were measured at rest and stress. The TTS cohort were Caucasian women with mean age of 64.6\u2009\u00b1\u20097.4\u2009years and similar coronary risk factor profile and EF to controls. Resting systolic blood pressure (SBP), LV end-diastolic volume, wall stress, and right ventricular fractional area change were higher in TTS patients compared with controls. Stress echo data showed similar exercise time, peak heart rate, and peak SBP in TTS patients vs. controls, but TTS patients had higher LV volumes, lower exercise LVEF (70\u2009\u00b1\u200910% vs. 78\u2009\u00b1\u20097%; P\u2009=\u20090.001), \u0394LVEF (4\u2009\u00b1\u20098% vs. 12\u2009\u00b1\u20095%; P\u2009&amp;lt;\u20090.001), and WMSI (1.4\u2009\u00b1\u20090.4 vs. 1\u2009\u00b1\u20090; P\u2009&amp;lt;\u20090.001) compared with controls. Twenty TTS patients had clear exercise-induced wall motion abnormalities, mainly involving the apex or more globally, with a mean \u0394LVEF of 1% compared with 12% in controls. Among the other 10 TTS patients, the \u0394LVEF was 10%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Symptomatic patients with previous TTS have a blunted contractile response to exercise. The therapeutic and prognostic implications of these findings need further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjci\/jeaa237","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T19:20:20Z","timestamp":1596568820000},"source":"Crossref","is-referenced-by-count":3,"title":["Reversible exercise-induced left ventricular dysfunction in symptomatic patients with previous Takotsubo syndrome: insights from stress echocardiography"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2981-0667","authenticated-orcid":false,"given":"H Yakup","family":"Yakupoglu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahrai","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxy","family":"Senior","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK"},{"name":"Cardiovascular Division, National Heart and Lung Institute, Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A John","family":"Baksi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK"},{"name":"Cardiovascular Division, National Heart and Lung Institute, Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander R","family":"Lyon","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK"},{"name":"Cardiovascular Division, National Heart and Lung Institute, Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajdeep S","family":"Khattar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK"},{"name":"Cardiovascular Division, National Heart and Lung Institute, Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,9,18]]},"reference":[{"key":"2020091802343645600_jeaa237-B1","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1002\/ccd.23441","article-title":"Incidence and angiographic characteristics of patients with apical ballooning syndrome (Takotsubo\/stress cardiomyopathy) in the HORIZONS-AMI trial: an analysis from a multicenter, international study of ST-elevation myocardial infarction","volume":"83","author":"Prasad","year":"2014","journal-title":"Cathet Cardiovasc 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