Monday preference in onset of takotsubo cardiomyopathy

Manfredini, Roberto; Citro, Rodolfo; Previtali, Mario; Vriz, Olga; Ciampi, Quirino; Pascotto, Marco; Tagliamonte, Ercole; Provenza, Gennaro; Manfredini, Fabio; Bossone, Eduardo; for the Takotsubo Italian Network investigators,

doi:10.1016/j.ajem.2009.04.023

« Previous Next »American Journal of Emergency Medicine
Volume 28, Issue 6 , Pages 715-719, July 2010

Monday preference in onset of takotsubo cardiomyopathy☆

Roberto Manfredini, MD
- Corresponding author. Tel.: +39 0532 236817; fax: +39 0532 236816.
- Department of Clinical and Experimental Medicine, Clinica Medica and Vascular Diseases Center, University of Ferrara, 44100 Ferrara, Italy
Rodolfo Citro, MD
- Cardiology Division, San Luca Hospital, Vallo della Lucania (SA) 84078, Italy
Mario Previtali, MD
- Cardiology Division IRCCS San Matteo, University of Pavia, Pavia 27100, Italy
Olga Vriz, MD
- Cardiology Division ASS 4, Hospital of San Daniele del Friuli (UD) 33038, Italy
Quirino Ciampi, MD
- Cardiology Division, Fatebenefratelli Hospital, Benevento 82100, Italy
Marco Pascotto, MD
- Cardiology Division, Fatebenefratelli Hospital, Naples 80100, Italy
Ercole Tagliamonte, MD
- Cardiology Division, Hospital Umberto I, Nocera Inferiore (SA) 84014, Italy
Gennaro Provenza, MD
- Cardiology Division, San Luca Hospital, Vallo della Lucania (SA) 84078, Italy
Fabio Manfredini, MD
- Vascular Rehabilitation Program and Vascular Diseases Center, University of Ferrara, 44100 Ferrara, Italy
Eduardo Bossone, MD, PhD
- Institute of Clinical Physiology, National Research Council, Lecce 73100, Italy
for the Takotsubo Italian Network investigators

Received 4 March 2009; received in revised form 30 March 2009; accepted 16 April 2009. published online 26 February 2010.

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.