Diastolic function improves after resolution of takotsubo cardiomyopathy

Summary Background Takotsubo cardiomyopathy ( TTC ) is a condition of reversible left ventricular ( LV ) systolic dysfunction. However, the diastolic function ( DF ) manifestations of TTC have not been widely investigated. We performed a bicentric study with retrospective analysis of DF in patients with TTC , during onset and at follow‐up. Methods Twenty‐eight patients with TTC (64 ± 10 years, F 24) were included. All underwent echocardiograms acutely and at the recovery phase (average three months later). Diastolic and systolic function parameters were recorded, including E‐wave velocity (E), A‐wave velocity, E/A ratio, relaxation (e′) and contractility (S′) based on tissue Doppler velocities of the mitral annuli, ejection fraction ( EF ), left atrial ( LA ) size and DF stages. Results Recovery, including the mean difference with 95% confidence interval, was associated with tending improvement (i.e. uncorrected significance) in E [13 cm s −1 (−24, −2·3), P  = 0·02] and in E/A ratio [0·2 (−0·41, −0·02), P  = 0·04], as well as significant improvement (after multiple comparison correction) in mean e′ [2·0 cm s −1 (−3·3, −1·2), P <0·001] and in A‐wave duration [29 ms (−46·7, −12·7), P  = 0·002]. LA area tended to decrease during recovery [−2 cm² (0·33, 2·4), P  = 0·01]. Improvement in DF stages was significant between the phases (21% versus 58% defined as normal DF , P  = 0·016). Improvement in LVEF correlated with improvement in mean e′ ( r  = 0·52, P  = 0·02). Conclusions TTC is associated with an acute impairment of conventional DF variables, which improves during recovery. DF recovery seems to occur in parallel with systolic recovery in patients with TTC .