A circadian variation in the cardiovascular parameters has been detected. It is plausible that the influence of the environment varies during different periods of the day. We investigated the association between daily emergency ambulance calls (EC) for paroxysmal atrial fibrillation (AF) that occurred during the time intervals of 8:00-13:59, 14:00-21:59, and 22:00-7:59, and weather conditions and exposure to CO and PM. We used Poisson regression to explore the association between the risk of EC for AF and environmental variables, adjusting for seasonal variation. Before noon, the risk was associated with an IQR (0.333 mg/m) increase in CO at lag 2-6 days above the median (RR = 1.15, P = 0.002); a protective impact of CO on previous day was observed (RR = 0.91, P = 0.018). During 14:00-21:59, a negative effect of air temperature below 1.9 °C (lag 2-3 days) was detected (per 10 °C decrease: RR = 1.17, P = 0.044). At night, the elevated risk was associated with wind speed above the median (lag 2-4 days) (per 1-kt increase: RR = 1.07, P = 0.001) and with PM at lag 2-5 days below the median (per IQR (7.31 μg/m) increase: RR = 1.21, P = 0.002). Individuals over 65 years of age were more sensitive to air pollution, especially at night (CO lag 2-3 days < median, per IQR (0.12 mg/m) increase: RR = 1.14, P = 0.045; PM lag 2-5 days < median, per IQR increase: RR = 1.32, P = 0.001). The associations of air pollution and other environmental variables with acute events may be analyzed depending on the time of the event.
The aim of this study was to identify associations of the parameters of heart rate variability (HRV) with the variations in geomagnetic activity (GMA), solar wind, and cosmic ray intensity (CRI) in patients after coronary artery bypass grafting or valve surgery in Kaunas, Lithuania, during 2008–2012. The data from 5-minute electrocardiograms (ECGs) in 220 patients were used. ECGs were carried out at 1.5 months, 1 year, and 2 years after the surgery (N = 495). A lower (higher) very-low-frequency-band (VLF) and a higher (lower) high-frequency band (HF) in normalised units (n.u.) were associated with a low maximal daily 3-hourly ap (the DST index > 1). A lower mean standard deviation of beat-to-beat intervals (SDNN) and VLF, LF, and HF powers were lower in patients when Ap < 8 occurred two days after the surgery, and a low solar wind speed (SWS) occurred two days before the ECG. The effect of CRI was non-significant if the linear trend was included in the model. Low GMA and a low SWS may effect some HRV variables in patients after open-heart surgery. The GMA during the surgery may affect the SDNN in short-term ECG during the longer period.
Background and objectives: To identify clinical, echocardiographic, and laboratory parameters that affect the early recurrence of atrial fibrillation (AF) after restoring sinus rhythm (SR) by electrical cardioversion (ECV), and to determine whether left atrial (LA) strain, as a noninvasive indicator reflecting fibrosis, is associated with laboratory indicators affecting the development of fibrosis, interleukin 6 (IL-6) or tumor necrosis factor α (TNF-α). Materials and Methods: The study included 92 persistent AF patients who underwent elective ECV. The effective maintenance of SR was evaluated after 40 ± 10 days of ECV. Echocardiography, inflammatory markers (high-sensitivity c-reactive protein (hs-CRP), IL-6, and TNF-α), and natriuretic peptides (N-terminal pro b-type natriuretic peptide (NT-proBNP) and N-terminal pro a-type natriuretic peptide (NT-proANP)) were assessed. Results: After a 40 ± 10 days observation period, 51 patients (55.4%) were in SR. Patients with AF recurrence had a significantly longer duration of AF (p = 0.008) and of arterial hypertension (p = 0.035), lower LA ejection fraction (p = 0.009), lower LA strain (p < 0.0001), higher left ventricular global longitudinal strain (p = 0.001), and a higher E/e‘ ratio (p < 0.0001). LA strain was an independent predictor of early AF recurrence (OR: 0.65; 95% Cl 0.5–0.9, p = 0.004). LA strain < 11.85% predicted AF recurrence with 70% sensitivity and 88% specificity (AUC 0.855, 95% CI 0.77–0.94, p < 0.0001). LA strain demonstrated the association with NT-proBNP (r = −0.489, p < 0.0001) and NT-proANP (r = −0.378, p = 0.002), as well as with hs-CRP (r = −0.243, p = 0.04). Conclusions: LA strain appeared to be the most accurate predictor of early AF recurrence after ECV in patients with persistent AF. LA strain inversely correlated with NT-proBNP and NT-proANP, but no significant association with any of the inflammatory markers was identified.
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