The aim of this study was to characterize left ventricular (LV) systolic function using 2-dimensional strain in Tako-Tsubo cardiomyopathy (TTC). Forty-two women were prospectively studied using 2-dimensional speckle-tracking echocardiography, divided into 3 groups: 14 patients with TTC (group 1), 14 patients with coronary artery disease (group 2), and 14 healthy patients (group 3). In patients with TTC, mean values of systolic peak velocity, strain, and strain rate were significantly lower than those in group 3 (p <0.04), but these values were similar between the basal septum and lateral wall, between the middle septum and lateral wall, and between the apical septum and lateral wall. LV ejection fractions were significantly improved during follow-up (p <0.0001). All values of velocities were significantly increased at day 7 compared with the acute phase (p < or =0.01). This improvement differed between the middle septum and lateral wall (p <0.0001), and values for the middle septum and lateral wall in patients with TTC were not significantly different from those observed in patients with coronary artery disease (p = NS). At 1-month follow-up, no significant difference was noted between patients in groups 1 and 3. In conclusion, 2-dimensional speckle-tracking echocardiography is a reliable tool for assessing circular dysfunction in patients with TTC. Once the acute phase has passed, TTC may mimic the LV systematized dysfunction observed in patients with coronary artery disease and so lead to misdiagnosis. This novel echocardiographic technique can also be used in the follow-up of LV functional recovery.