Monday preference in onset of takotsubo cardiomyopathy - 12/08/11

Doi : 10.1016/j.ajem.2009.04.023

Roberto Manfredini, MD ^⁎,^a , Rodolfo Citro, MD ^b, Mario Previtali, MD ^c, Olga Vriz, MD ^d, Quirino Ciampi, MD ^e, Marco Pascotto, MD ^f, Ercole Tagliamonte, MD ^g, Gennaro Provenza, MD ^b, Fabio Manfredini, MD ^h, Eduardo Bossone, MD, PhD ⁱ
for the Takotsubo Italian Network investigators
^a Department of Clinical and Experimental Medicine, Clinica Medica and Vascular Diseases Center, University of Ferrara, 44100 Ferrara, Italy
^b Cardiology Division, San Luca Hospital, Vallo della Lucania (SA) 84078, Italy
^c Cardiology Division IRCCS San Matteo, University of Pavia, Pavia 27100, Italy
^d Cardiology Division ASS 4, Hospital of San Daniele del Friuli (UD) 33038, Italy
^e Cardiology Division, Fatebenefratelli Hospital, Benevento 82100, Italy
^f Cardiology Division, Fatebenefratelli Hospital, Naples 80100, Italy
^g Cardiology Division, Hospital Umberto I, Nocera Inferiore (SA) 84014, Italy
^h Vascular Rehabilitation Program and Vascular Diseases Center, University of Ferrara, 44100 Ferrara, Italy
ⁱ Institute of Clinical Physiology, National Research Council, Lecce 73100, Italy

^⁎Corresponding author. Tel.: +39 0532 236817; fax: +39 0532 236816.

Abstract

Objective

Acute cardiovascular events show definite temporal patterns of occurrence. Takotsubo cardiomyopathy (TTC) has been recently shown to exhibit a seasonal (summer) and circadian (morning) temporal distribution. The aim of this study, based on the database of a multicenter Italian network, was to investigate the possible existence of a weekly pattern of onset of TTC.

Methods

The study included all cases of TTC admitted to the coronary care unit of 8 referral cardiac centers in Italy (five in Southern Italy and three in Northern Italy, respectively), belonging to the Takotsubo Italian Network (January 2002-December 2008). Day of admission was categorized into seven 1-day intervals according by week, and chronobiological analysis was performed by partial Fourier series.

Results

The database included 112 patients with TTC (92.9% females). The weekly distribution identified the highest number of cases on Monday and the lowest on Saturday. Chronobiologic analysis yielded a rhythmic pattern with a significant peak on Monday (P = .036).

Conclusions

This study confirms a Monday preference for TTC occurrence on Monday, similar to that reported for acute myocardial infarction. Stress of starting weekly day life activities, could play a triggering role.

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Plan

☆	Funding support: supported, in part, by a scientific grant “Finanziamento per ricerca locale - FAR” from the University of Ferrara, Italy.

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Vol 28 - N° 6

P. 715-719 - juillet 2010 Retour au numéro

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Monday preference in onset of takotsubo cardiomyopathy - 12/08/11

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