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• W2014487213 abstract "We greatly appreciated the interesting paper by Song et al 1 Song B.J. Oh J.H. Kim H.J. et al. Chronobiological variation in the occurrence of Tako-tsubo cardiomyopathy: experiences from two tertiary cardiovascular centers. Heart Lung. 2012 Oct 18; (pii: S0147-9563(12)00328-7. doi:10.1016/j.hrtlng.2012.09.004. [Epub ahead of print]) Google Scholar regarding the chronobiological occurrence of Tako-tsubo cardiomyopathy (TTC). The Authors, collecting a sample of 137 patients in two tertiary cardiovascular centers in Korea, reported preferred peaks of occurrence in summer, Monday, and morning. Although summer and morning peaks represent confirmed evidence in the available literature, 2 Bossone E. Citro R. Eagle K.A. Manfredini R. Tako-Tsubo cardiomyopathy: is there a preferred time of onset?. Intern Emerg Med. 2011; 6: 221-226 Crossref PubMed Scopus (23) Google Scholar , 3 Deshmukh A. Kumar G. Pant S. Rihal C. Murugiah K. Mehta J.L. Prevalence of Takotsubo cardiomyopathy in the United States. Am Heart J. 2012; 164: 66-71.e1 Abstract Full Text Full Text PDF PubMed Scopus (240) Google Scholar this studies provide further support to the only previous study reporting a Monday peak in occurrence of TTC, not included in the reference selection. The Takotsubo Italian Network investigators, in fact, investigated their cohort of consecutive patients (n = 112, years 2002–2008) and found a statistically significant circaseptan (about 7-day) rhythm characterized by a peak on Monday and nadir on Saturday (p < 0.05). 4 Manfredini R. Citro R. Previtali M. et al. for the Takotsubo Italian Network InvestigatorsMonday preference in onset of Takotsubo cardiomyopathy. Am J Emerg Med. 2010; 28: 715-719 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar However, the observed versus expected distribution of admissions between weekend and weekdays was not significantly different. It has to be stressed that the weekly variation observed by Song et al was obtained by conventional statistics (chi-square test) that allows one to demonstrate differences between frequency rates. In turn, we used a validated chronobiological method based on inferential Fourier analysis (ChronoLab), 5 Mojòn A. Fernàndez J.R. Hermida R.C. Chronolab: an interactive software package for chronobiologic time series analysis written for the Macintosh computer. Chronobiol Int. 1992; 9: 403-412 Crossref PubMed Scopus (260) Google Scholar written to explore cyclical phenomena and to demonstrate a repetitivity of the analyzed phenomenon. Of course, the implications for prevention of a certain event are much stronger in this latter case. In these last years, Monday has been recognized as a critical day for occurrence of acute cardiovascular events, such as myocardial infarction, 6 Gnecchi-Ruscone T. Piccaluga E. Guzzetti S. Contini M. Montano N. Nicolis E. Mornings and Monday: critical periods for the onset of acute myocardial infarction. Eur Heart J. 1994; 15: 882-887 PubMed Google Scholar , 7 Willich S.N. Lowel H. Lewis M. Hormann A. Arntz H.R. Keil U. Weekly variation of acute myocardial infarction: increased Monday risk in the working population. Circulation. 1994; 90: 87-93 Crossref PubMed Scopus (234) Google Scholar , 8 Spielberg C. Falkenhahm D. Willich S.H. Weqscheider K. Voller H. Circadian, day of week and seasonal variability in myocardial infarction: comparison between working and retired patients. Am Heart J. 1996; 132: 579-584 Abstract Full Text PDF PubMed Scopus (141) Google Scholar , 9 Manfredini R. Manfredini F. Boari B. et al. Seasonal and weekly patterns of hospital admissions for nonfatal and fatal myocardial infarction. Am J Emerg Med. 2009; 27: 1096-1102 Google Scholar rupture or dissection of aortic aneurysms, 10 Manfredini R. Boari B. Salmi R. et al. Day-of-week variability in the occurrence and outcome of aortic diseases: does it exist?. Am J Emerg Med. 2008; 26: 363-366 Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar transient ischemic attack, 11 Manfredini R. Manfredini F. Boari B. et al. Temporal patterns of hospital admissions for transient ischemic attack. A retrospective population-based study in the Emilia-Romagna region of Italy. Clin Appl Thromb Hemost. 2010; 16: 153-160 Crossref PubMed Scopus (30) Google Scholar and stroke. 12 Manfredini R. Casetta I. Paolino E. et al. Monday preference in onset of ischemic stroke. Am J Med. 2001; 111: 401-413 Abstract Full Text Full Text PDF PubMed Scopus (64) Google Scholar , 13 Manfredini R. Manfredini F. Boari B. Salmi R. Gallerani M. The Monday peak in the onset of ischemic stroke is independent of major risk factors. Am J Emerg Med. 2009; 27: 244-246 Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar A meta-analysis study aimed to quantify the excess risk associated with the Monday peak in cardiovascular mortality, found an increased pooled odds ratio of 1.19. 14 Witte D.R. Grobbee D.E. Bots M.L. Hoes A.W. Meta-analysis of excess cardiac mortality on Monday. Eur J Epidemiol. 2005; 20: 401-416 Crossref PubMed Scopus (48) Google Scholar Stress could represent a possible pivotal cause, and the study by Song et al 1 Song B.J. Oh J.H. Kim H.J. et al. Chronobiological variation in the occurrence of Tako-tsubo cardiomyopathy: experiences from two tertiary cardiovascular centers. Heart Lung. 2012 Oct 18; (pii: S0147-9563(12)00328-7. doi:10.1016/j.hrtlng.2012.09.004. [Epub ahead of print]) Google Scholar confirmed the Monday peak in the subgroups of patients with previous emotional or physical stressor. Of course, we fully agree with the Authors that further studies on temporal frames at highest risk of occurrence, and possible more-in-depth knowledge of underlying causes, might have implications for prevention. 15 Manfredini R. Eagle K.A. Bossone E. Acute myocardial infarction and Tako-tsubo cardiomyopathy: could time of onset help to diagnose?. Expert Rev Cardiovasc Ther. 2011; 9: 123-126 Crossref PubMed Scopus (11) Google Scholar" @default.
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• W2014487213 title "Temporal occurrence of Takotsubo cardiomyopathy: A further evidence for a Monday peak" @default.
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