The Clinical Efficacy of Cardiac Rehabilitation in Takotsubo Syndrome.

Abstract

Purpose Despite normalization of left ventricular ejection fraction (LVEF), symptoms and impaired exercise capacity can persist ~1 year after Takotsubo syndrome (TTS). We evaluated the impact of cardiac rehabilitation (CR) on cardiac structure and function, functional exercise capacity, and health-related quality of life (HRQoL) in patients with TTS. Methods Patients with TTS who completed (TTS-CR, n = 33) and did not complete (TTS-CTL, n = 24) CR were retrospectively analyzed. Cardiac structure and function (via echocardiogram) were assessed at index hospitalization and follow-up (post-CR in TTS-CR; >1 month later in TTS). The 6-minute walk test distance and Dartmouth Cooperative Functional Assessment Charts quality-of-life score were assessed pre- and post-CR (TTS-CR). Major adverse cardiovascular events within 1-year post index hospitalization were recorded (all groups). Results The LVEF improved similarly in TTS-CR (39 ± 9% vs 60 ± 6%) and TTS (39 ± 10% vs 60 ± 7%, P = .58). The left ventricular end-diastolic volume decreased similarly in TTS-CR (125 ± 40 vs 105 ± 37 mL) and TTS-CTL (126 ± 26 vs 109 ± 27 mL, P = .81). In TTS-CR, 6-minute walk test distance (330 ± 126 vs 364 ± 97 m, P = .007) and Dartmouth Cooperative Functional Assessment Charts quality-of-life score (22 ± 6 vs 19 ± 7 m, P = .04) improved significantly from pre- to post-CR. Rates of major adverse cardiovascular events were similar between groups (P > .05). Conclusions Cardiac rehabilitation did not enhance cardiac structural or functional recovery but did improve functional exercise capacity and HRQoL in patients with TTS.