Chronobiological variation in the occurrence of Tako-tsubo cardiomyopathy: experiences of two tertiary cardiovascular centers.
BACKGROUND
There have been few data to review and analyze the temporal preference of the onset of Tako-tsubo cardiomyopathy (TTC). Aim of this study was to investigate chronobiological variations in the occurrence of TTC and changes of these variations according to age and gender.


METHODS
One hundred and thirty-seven patients were enrolled from our TTC registry database from January 2004 to December 2010 in Korea.


RESULTS
The median age of the entire study population was 59 years (inter-quartile range 53-72 years). The majority of patients were women (n = 101, 74%). The onset of TTC differed as a function of season (P = .001), with the peak in July and the nadir in March. Events were most frequent in summer (n = 53%, 38.7%) and least so in winter (n = 26, 19%, chi-square = 13.92, P = .003). TTC was most frequent in the morning (n = 56, 40.9%) and least so at night (n = 22, 16.1%, chi-square = 21.98, P = .001). Also, TTC was most frequent on Monday (n = 34, 24.8%) and least so on Saturday (n = 7, 5.1%, chi-square = 30.44, P = .001). Stressor pattern, age and gender do not influence these increases of occurrence in summer, on Monday, and in the morning of TTC.


CONCLUSIONS
TTC seems to exhibit a temporal variation of occurrence with preferred peaks during morning, Monday, and summer. Stressor pattern, age and gender do not influence these temporal patterns of the occurrence of TTC. Further studies are needed to investigate the potential link between chronobiological variations of TTC onset and underlying pathophysiologic mechanisms.
Division of Cardiology, Cardiac and Vascular Center, Department of Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Bong Gun
BG
Song
Ju Hyeon
JH
Oh
Hyun-Joong
HJ
Kim
Sung Hea
SH
Kim
Sang Man
SM
Chung
Mirae
M
Lee
Gu Hyun
GH
Kang
Yong Hwan
YH
Park
Woo Jung
WJ
Chun
D017677:Age Distribution; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010507:Periodicity; D011379:Prognosis; D012008:Recurrence; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012621:Seasons; D017678:Sex Distribution; D054549:Takotsubo Cardiomyopathy / Q000453:epidemiology*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*