: Background: Anxiety and depressive disorders represent predisposing factors for the
autonomic dysfunctions that characterize the acute phase of Takotsubo syndrome (TS). However,
there is insufficient data on this relationship after the acute event. The present study aimed at
evaluating the psychological and autonomic status of patients with a history of TS. Methods: Ten TS
patients whose acute event occurred at least 1 year prior to the evaluation and nine healthy age- and
sex-matched subjects were evaluated. The cardiovascular assessment included a clinical examination,
beat-to-beat heart rate monitoring to assess heart rate variability, and a psychological examination
using the 16 Personality Factors-C Form (16PF), the Acceptance and Action Questionnaire-II, the
Coping Orientations to Problems Experienced (COPE), the Beck Depression Inventory-II, and the
State-Trait Anxiety Inventory (STAI). Results: TS patients scored significantly higher on the STAI
(i.e., Anxiety Trait), 16PF (i.e., Tension), and COPE (i.e., Transcendental Orientation). TS patients also
showed lower heart rate variability. Moreover, a significant inverse correlation was found between
sympathetic tone (LF/HF ratio) and coping orientation. Conclusions: Long after the acute event, TS
patients are characterized by elevated anxiety, high tension, and a specific religious coping strategy
