title: Monday preference in onset of takotsubo cardiomyopathy.
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.
authors.affiliation: Department of Clinical and Experimental Medicine, Clinica Medica and Vascular Diseases Center, University of Ferrara, 44100 Ferrara, Italy. mfr@unife.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredini
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Citro
authors.forename: Mario
authors.initials: M
authors.lastname: Previtali
authors.forename: Olga
authors.initials: O
authors.lastname: Vriz
authors.forename: Quirino
authors.initials: Q
authors.lastname: Ciampi
authors.forename: Marco
authors.initials: M
authors.lastname: Pascotto
authors.forename: Ercole
authors.initials: E
authors.lastname: Tagliamonte
authors.forename: Gennaro
authors.initials: G
authors.lastname: Provenza
authors.forename: Fabio
authors.initials: F
authors.lastname: Manfredini
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003325:Coronary Care Units; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008875:Middle Aged; D010507:Periodicity; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D054549:Takotsubo Cardiomyopathy / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*