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Tako-tsubo cardiomyopathy: is there a preferred time of onset?

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Abstract

The occurrence of major cardiovascular events is not randomly distributed over time, but exhibits chronobiological patterns, i.e., circadian, weekly, or seasonal. No systematic studies on the temporal preference of onset of Tako-tsubo cardiomyopathy (TTC) are known. We performed a computer-assisted search of the literature (from 2000 to January 2010), with the following search terms: transient left ventricular apical ballooning syndrome, takotsubo-like left ventricular dysfunction, ampulla cardiomyopathy, tako-tsubo or takotsubo cardiomyopathy, tako-tsubo, apical ballooning. Criteria for publication inclusion were (a) reporting of original data, (b) inclusion of at least 30 or more cases, (c) adherence to the requested diagnostic criteria for TTC. We focused on studies including in their purposes the “time of onset” of events. Out of the 19 studies found, 7 (4 from Europe, 1 each from Asia, Australia and USA) specifically addressed this aspect. A circadian (morning) and a seasonal (summer) higher frequency of events was found. TTC seems to exhibit a temporal variation of onset, with preferred peaks during morning and summer. Stress and catecholamines, also according to their temporal organization, might play a pivotal role. The demonstration of time frames characterized by highest frequency of occurrence might help to try to ensure maximal protection during particularly vulnerable periods.

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Acknowledgments

This paper is funded (in part) by a scientific institutional grant (FondoAteneoRicerca, FAR) by the University of Ferrara, Italy.

Conflict of interest

No author has any conflict of interest regarding this paper to disclose. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper, and its final contents.

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Authors and Affiliations

  1. Department of Cardiac Surgery, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy

    Eduardo Bossone

  2. Cardiology Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy

    Rodolfo Citro

  3. University of Michigan Cardiovascular Center, Ann Arbor, MI, 48109-5852, USA

    Kim A. Eagle

  4. Department of Clinical and Experimental Medicine, Clinica Medica and Vascular Diseases Center, University of Ferrara, Via Savonarola 9, 44100, Ferrara, Italy

    Roberto Manfredini

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  1. Eduardo Bossone
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  2. Rodolfo Citro
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  3. Kim A. Eagle
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  4. Roberto Manfredini
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Correspondence to Roberto Manfredini.

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Bossone, E., Citro, R., Eagle, K.A. et al. Tako-tsubo cardiomyopathy: is there a preferred time of onset?. Intern Emerg Med 6, 221–226 (2011). https://doi.org/10.1007/s11739-010-0480-8

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  • DOI: https://doi.org/10.1007/s11739-010-0480-8

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