Arntz H R, Willich S N, Schreiber C, Brüggemann T, Stern R, Schultheiss H P
Department of Cardiopulmology, Benjamin Franklin Medical Center, Free University Berlin, Berlin, Germany.
Eur Heart J. 2000 Feb;21(4):315-20. doi: 10.1053/euhj.1999.1739.
Several studies have reported circadian and seasonal variations in acute cardiovascular disease. In addition, a weekly variation has been observed in acute myocardial infarction. The aim of our study was to determine the circadian weekly, and seasonal variations of sudden death utilizing population-based data.
We analysed the emergency medical system data of Berlin (West) from 1987-1991 with respect to all consecutive sudden deaths in subjects >18 years (n=24 061). There was a marked circadian variation of sudden death, with a minimum between 0 and 6 h and a maximum between 6 and 12 h (P<0.0001) for every day of the week. A minimum of events occurred on Sundays (n=3143), and a maximum on Mondays (n=3721), corresponding to a relative increase of 18.3% (P<0.0001). The increase was more pronounced (23.6%) in patients < or =65 than in patients >65 (15.7%). In addition, we found a significant seasonal variation (P<0.0001) in events, with a maximum during winter (December to February, n=6493), and a minimum during summer (June to August, n=5472), corresponding to a relative difference of 18.7%. The seasonal variation was more pronounced in patients >65 years.
The present analyses demonstrate marked variations in the occurrence of sudden death with peaks during morning hours, on Mondays, and during winter months. The findings suggest that the onset of sudden death may be associated with endogenous rhythms and external factors including climatic conditions.
多项研究报告了急性心血管疾病的昼夜和季节变化。此外，急性心肌梗死存在每周变化。我们研究的目的是利用基于人群的数据确定猝死的昼夜、每周和季节变化。
我们分析了1987年至1991年柏林（西柏林）急救医疗系统数据中所有18岁以上连续猝死病例（n = 24061）。猝死存在明显的昼夜变化，一周中每天0至6时猝死发生率最低，6至12时最高（P<0.0001）。周日猝死事件最少（n = 3143），周一最多（n = 3721），相对增加18.3%（P<0.0001）。65岁及以下患者的增加更为明显（23.6%），高于65岁以上患者（15.7%）。此外，我们发现事件存在显著的季节变化（P<0.0001），冬季（12月至2月，n = 6493）发生率最高，夏季（6月至8月，n = 5472）最低，相对差异为18.7%。65岁以上患者的季节变化更为明显。
目前的分析表明，猝死发生率存在明显变化，在上午时段、周一和冬季月份出现高峰。研究结果表明，猝死的发生可能与内源性节律和包括气候条件在内的外部因素有关。
