Cardiac rehabilitation in Takotsubo cardiomyopathy: Predictors of utilization and effects of exercise training.

Single-centre retrospective design, so findings may not apply elsewhere. Exercise outcomes were measured before and after participation in the same patients, with no control group or randomisation, so improvement cannot be attributed to cardiac rehabilitation rather than recovery over time or other care. Only patients living closest to the centre were counted for participation rates, and patients who attended other regional programmes were not captured. Only 12 of 45 enrolled patients completed 30 or more sessions, and the database did not record reasons for dropout or adverse events. Exercise capacity was based on functional exercise capacity during sessions, not formal stress testing or peak exercise capacity. Takotsubo cardiomyopathy is not a sole qualifying diagnosis for cardiac rehabilitation, and the authors note lack of insurance reimbursement, which affects generalisability and referral pathways.

The authors declared no competing interests; the supplied publication metadata lists NIH extramural research support.

Do not conclude that cardiac rehabilitation causes recovery in Takotsubo cardiomyopathy. The exercise capacity gain was an uncontrolled before-and-after result, and the authors state that randomised trials are needed and that cardiac rehabilitation is not yet standard care for this population.