Regional mechanical dyssynchrony and shortened systole are present in people with Takotsubo syndrome

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. 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. 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. 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. People with Takotsubo syndrome have temporarily weakened heart muscle, and this is often triggered by emotional or physical stress. We compared the heart pressure and volume between people with Takotsubo syndrome and healthy individuals. Our findings showed that people with Takotsubo syndrome have weaker heart muscles and irregular contractions, especially in the middle and tip of the heart, despite having normal electrical signals. This means that their hearts are less efficient at pumping blood. This study provides additional details about the impact of Takotsubo syndrome on heart function. Improved understanding of these issues could lead to better diagnosis and treatment for people with this condition in the future. Reil, Sequeira et al. investigate the role of mechanical dyssynchrony in Takotsubo Syndrome, revealing significant segmental dysfunction in the left ventricle. Their findings highlight the mechanical inefficiencies and reduced systolic function in Takotsubo patients, independent of electrical conduction abnormalities.