Chronobiological variation in the occurrence of Tako-tsubo cardiomyopathy: experiences of two tertiary cardiovascular centers

Abstract

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.