Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Long-Term Functional Limitations on Cardiopulmonary Exercise Testing in Emotions-Triggered Takotsubo Syndrome

Version 1 : Received: 4 December 2023 / Approved: 5 December 2023 / Online: 5 December 2023 (14:40:09 CET)

A peer-reviewed article of this Preprint also exists.

Jabbour, J.P.; Arcari, L.; Cacciotti, L.; Magrì, D.; Recchioni, T.; Valeri, L.; Maggio, E.; Vizza, C.D.; Badagliacca, R.; Papa, S. Long-Term Functional Limitations on Cardiopulmonary Exercise Testing in Emotion-Triggered Takotsubo Syndrome. Journal of Clinical Medicine 2024, 13, 1163, doi:10.3390/jcm13041163. Jabbour, J.P.; Arcari, L.; Cacciotti, L.; Magrì, D.; Recchioni, T.; Valeri, L.; Maggio, E.; Vizza, C.D.; Badagliacca, R.; Papa, S. Long-Term Functional Limitations on Cardiopulmonary Exercise Testing in Emotion-Triggered Takotsubo Syndrome. Journal of Clinical Medicine 2024, 13, 1163, doi:10.3390/jcm13041163.

Abstract

In patients with prior Takotsubo syndrome (TTS), long lasting functional cardiac limitations were described as compared with normal subjects. Emotions-triggered Takotsubo syndrome (E-TTS) has more favorable outcomes than TTS preceded by a physical trigger or by no identifiable fac-tors. The aim of the present study was to assess long-term cardiac functional limitations in a co-hort of asymptomatic E-TTS patients. We enrolled n=39 asymptomatic patients with a diagnosis of E-TTS. Cardiopulmonary exercise tests (CPET) were performed at 30 [12-40] months median fol-low-up from the acute event. A cohort of n=39 individuals matched for age, sex, body mass index and comorbidities served as control. Despite recovery of left ventricular ejection fraction, patients with prior E-TTS had lower peak VO2 and percentage of predicted peak VO2 (17.8 ± 3.6 vs 22.5 ± 6.5; P < 0.001 and 75.2 ± 14.1 % vs 100.6 ± 17.1%, P <0.001), VO2 at anaerobic threshold (AT) (11.1 [10.1-12.9] vs 14.4 [12.5-18.7]; P <0.001), peak O2 pulse (9.7 ± 2.5 vs 13.1 ± 3.5; P <0.001) and higher VE/VCO2 slope (30.4 ± 3.7 vs 27.2 ± 3.5; P <0.001) compared with matched controls. We found no statistically significant differences in heart rate reserve (HRR), respiratory equivalent ratio (RER), mean blood pressure and peak PetCO2 between patients and controls. Despite its favorable out-come, patients with E-TTS in our population were found to have subclinical long-term functional cardiac limitations as compared with a control cohort.

Keywords

Cardiopulmonary exercise test; Takotsubo syndrome; Long-term functional limitations; Heart failure

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

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