Communications medicine, Volume 4, Issue 1, 1 1 2024, Pages 223 Regional mechanical dyssynchrony and shortened systole are present in people with Takotsubo syndrome. Reil JC, Sequeira V, Reil GH, Steendijk P, Maack C, Fink T, Rawish E, Eitel I, Stiermaier T

Background

Takotsubo syndrome is characterized by transient regional systolic dysfunction, left ventricular (LV) dilatation, and edema, often occurring without obstructive coronary artery disease. The mechanisms underlying this stress-induced condition, especially the role of mechanical dyssynchrony in affecting systolic function, remain poorly understood.

Methods

In our study, we evaluated global LV function and mechanical dyssynchrony in 24 Takotsubo patients compared to 20 controls by analyzing pressure-volume loops and time-varying elastance. Additionally, we monitored changes in LV segmental volume and internal flow.

Results

Here we show a significant reduction in global myocardial contractility and pronounced mechanical dyssynchrony in Takotsubo syndrome, particularly in the mid and apical LV segments, without disturbances in electrical conduction.

Conclusions

Our findings reveal substantial mechanical dyssynchrony in Takotsubo patients, characterized by increased internal flow and a shortened systolic ejection time. This indicates a mechanical basis for the inefficient LV function in Takotsubo syndrome, independent of electrical conduction abnormalities.

Commun Med (Lond). 2024 11;4(1):223