{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T10:31:23Z","timestamp":1782469883813,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T00:00:00Z","timestamp":1511481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Takotsubo syndrome (TTS) is peculiar clinical condition often resembling an acute coronary syndrome and mostly affecting postmenopausal women after a stressful trigger. TTS was initially thought to be a relatively benign condition. However, current data have shown it may be associated with considerable inpatient morbidity and carry a small, but important, mortality risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We hypothesized that left ventricular (LV) regional and global longitudinal strain (GLS) assessed with 2D speckle tracking echocardiography could identify early systolic functional impairment and predict in\u2010hospital cardiovascular events. We conducted a retrospective descriptive study reviewing patients with the discharge diagnosis of TCM between 2003 and 2016 at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred patients with TSS met the Modified Mayo Clinic criteria. Using 2D speckle tracking echocardiography, two independent cardiologists assessed the LV GLS as well as the longitudinal strain (LS) of 7 individual segments [basal\u2010septal (BS); mid\u2010septal (MS), apical\u2010septal (AS), apex, basal\u2010lateral (BL), mid\u2010lateral (ML), and apical\u2010lateral (AL)]. The inter\u2010observer variability was &lt;5%. Mean age was 69.1\u00a0years, 87% were females, and 53% were African Americans. Mean initial LV EF was 32%\u00a0\u00b1\u00a09.8%. In univariate analysis, patients with worse BL, ML, and GLS profiles (means: \u22125.7; \u22123.3, and \u22124, respectively) had higher in\u2010hospital mortality (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). Worse BL and ML profiles (means: \u22128.6 and \u22127.3, respectively) were associated with higher prevalence of MACE (major adverse cardiovascular outcomes) (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). In a multivariate analysis, mid\u2010lateral strain\u00a0\u2265\u00a0\u22127 and basolateral strain\u00a0\u2265\u00a0\u221210 were independent predictors of in\u2010hospital mortality and MACE\u00a0+\u00a0in\u2010hospital heart failure, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Assessment of LV global and segmental longitudinal strain by speckle tracking has important prognostic value in the acute phase of TTS. Additional large\u2010scale studies will be needed to confirm our findings<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13762","type":"journal-article","created":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T08:09:15Z","timestamp":1511510955000},"page":"179-183","source":"Crossref","is-referenced-by-count":35,"title":["Usefulness of left ventricular strain analysis in patients with takotsubo syndrome during acute phase"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-5628","authenticated-orcid":false,"given":"Andre","family":"Dias","sequence":"first","affiliation":[{"name":"Department of Cardiology Einstein Medical Center The Sidney Kimmel College of Medicine at Thomas Jefferson University  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiliana","family":"Franco","sequence":"additional","affiliation":[{"name":"Department of Cardiology Einstein Medical Center The Sidney Kimmel College of Medicine at Thomas Jefferson University  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manolo","family":"Rubio","sequence":"additional","affiliation":[{"name":"Department of Medicine Einstein Medical Center  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Bhalla","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Kentucky  Lexington KY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg S.","family":"Pressman","sequence":"additional","affiliation":[{"name":"Department of Medicine Einstein Medical Center  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Amanullah","sequence":"additional","affiliation":[{"name":"Department of Cardiology Einstein Medical Center The Sidney Kimmel College of Medicine at Thomas Jefferson University  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Hebert","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent M.","family":"Figueredo","sequence":"additional","affiliation":[{"name":"Department of Medicine Einstein Medical Center  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl032"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.05.060"},{"key":"e_1_2_6_4_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ijcard.2009.09.468","article-title":"Cardioembolic outcomes in stress\u2010related cardiomyopathy complicated by ventricular thrombus: a systematic review of 26 clinical studies","volume":"141","author":"Gregorio C","year":"2010","journal-title":"Int J 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