title: Climatic variables in Takotsubo cardiomyopathy: role of temperature.
abstract: BACKGROUND
  Recent studies documented a seasonal (summer) and circadian (morning) temporal distribution of takotsubo cardiomyopathy (TTC).
  
  
  OBJECTIVE
  The aim of our study was to investigate whether there is a relationship among season, temperature and the occurrence of TTC. A second aim of our study was the comparison of climatic variables in Takotsubo cardiomyopathy versus acute myocardial infarction (AMI).
  
  
  METHODS
  We enrolled consecutive patients with TTC in three Italian centres and, for comparison consecutive patients with AMI. The frequency of TTC and AMI patients according to month, season and quartiles of temperature (I quartile: 9.8-15°, II quartile: 15-19°, III quartile: 19-25° and IV quartile: 25-38°C) was reported. Climatic variables of TTC and AMI patients were compared.
  
  
  RESULTS
  We included in the study 85 patients with TTC and 900 patients with AMI. It was not observed a significant peak in the occurrence of TTC during summer time; however, when compared with AMI, TTC was more frequent in summer. We found an absolute higher frequency of TTC cases with warmer temperatures. TTC cases occurred during warmer temperatures than AMI.
  
  
  CONCLUSIONS
  Our study does not confirm a summer preference for TTC occurrence, as reported by previous studies, even if, compared with AMI, TTC is more frequent in summer. During warmest days, it was recorded the highest incidence of TTC.
authors.affiliation: aDivision of Cardiology, A.O. U. Policlinico 'P. Giaccone', University of Palermo bDivision of Cardiology 'G.F. Ingrassia' Hospital, Palermo cDivision of Cardiology, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Novo
authors.forename: Enrica
authors.initials: E
authors.lastname: Mariano
authors.forename: Salvatore
authors.initials: S
authors.lastname: Giambanco
authors.forename: Vito
authors.initials: V
authors.lastname: Bonomo
authors.forename: Girolamo
authors.initials: G
authors.lastname: Manno
authors.forename: Annalisa
authors.initials: A
authors.lastname: Viele
authors.forename: Salvatore
authors.initials: S
authors.lastname: Evola
authors.forename: Francesco
authors.initials: F
authors.lastname: Giambanco
authors.forename: Pasquale
authors.initials: P
authors.lastname: Assennato
authors.forename: Salvatore
authors.initials: S
authors.lastname: Novo
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D012621:Seasons; D054549:Takotsubo Cardiomyopathy / Q000453:epidemiology*; D013696:Temperature