Ben Ahmed H, Bellali M, Allouche E, Allouche M, Belhadj A, Ben Khelil M, Shimi M, Razghallah R, Banasr A, Benzarti A, Bezdah L, Hamdoun M
Service de cardiologie, Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie.
Service de Médecine Légale Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie.
Ann Cardiol Angeiol (Paris). 2023 Jun;72(3):101597. doi: 10.1016/j.ancard.2023.101597. Epub 2023 Apr 17.
Several studies have suggested a circadian and septadian pattern of incidence of sudden cardiac death with a morning peak and a Monday peak.
To analyze the circadian and septadian pattern of occurrence of sudden cardiac death in the eight northern Tunisian governorates.
We prospectively collected epidemiological and autopsy data of sudden cardiac death victims occurring in the northern region of Tunisia between January 2013 and December 2019.
The population included 1834 men (79.6%) and 468 women (20.4%) with a mean age of 56.5 ± 14 years. Smoking (53.9%) was the most prevalent cardiovascular risk factor. One-fifth (20.9%) of victims had known heart disease, and 3% had a family history of sudden death. ischemic heart disease was the leading cause of sudden death (46.8% of cases). One- fourth (25.7%) of autopsies were negative. Analysis of the circadian pattern of occurrence of sudden cardiac death identified a peak (36.1%, p < 0.001) between midnight and 6 am. This nocturnal excess mortality was significant (p < 0.001) and independent of sex (34.1 % in men and 43.8 % in women) and cause of death (39.3 % of cases of sudden ischemic death and 33.3 % of cases of nonischemic death). Moreover, there was a significant septadian variability in the occurrence of sudden death (p: 0.0015), with a peak on Friday (15.8 %, p: 0.042).
This study showed a peak of sudden death between midnight and 6 am, and on Fridays, confirming the modification of the classic circadian and septadian pattern of sudden death occurrence. These results may help optimize the deployment of emergency mobile teams and structures during the most vulnerable periods.
多项研究表明，心源性猝死的发生率存在昼夜节律和七日节律模式，有早晨高峰和周一高峰。
分析突尼斯北部八个省份心源性猝死发生的昼夜节律和七日节律模式。
我们前瞻性收集了2013年1月至2019年12月期间突尼斯北部地区心源性猝死受害者的流行病学和尸检数据。
研究人群包括1834名男性（79.6%）和468名女性（20.4%），平均年龄为56.5±14岁。吸烟（53.9%）是最常见的心血管危险因素。五分之一（20.9%）的受害者患有已知的心脏病，3%有猝死家族史。缺血性心脏病是猝死的主要原因（46.8%的病例）。四分之一（25.7%）的尸检结果为阴性。对心源性猝死发生的昼夜节律模式分析发现，午夜至凌晨6点之间出现一个高峰（36.1%，p<0.001）。这种夜间超额死亡率具有显著性（p<0.001），且与性别（男性为34.1%，女性为43.8%）和死亡原因（缺血性猝死病例的39.3%和非缺血性死亡病例的33.3%）无关。此外，猝死的发生存在显著的七日变异性（p：0.0015），周五出现高峰（15.8%，p：0.042）。
本研究显示午夜至凌晨6点之间以及周五出现猝死高峰，证实了猝死发生的经典昼夜节律和七日节律模式有所改变。这些结果可能有助于在最脆弱时期优化应急移动团队和机构的部署。
