Background

Sudden cardiac death (SCD) is relatively common and may occur in apparently healthy individuals. The role of seasonal variation as a risk factor for SCD is poorly understood. The aim of this study was to investigate whether SCD exhibits a predilection for specific seasons.

Methods

We reviewed a database of 4751 cases of SCD (mean age 38 ± 17 years) referred to our center for cardiac pathology at St George’s University of London between 2000 and 2018. Clinical information was obtained from referring coroners who were asked to complete a detailed questionnaire. All cases underwent macroscopic and histological evaluation of the heart, by expert cardiac pathologists.

Results

SCD was more common during winter (26%) and rarer during summer (24%), p= 0.161. Significant seasonal variation was not observed among cases of sudden arrhythmic death syndrome (SADS, 2910 cases) in which the heart is structurally normal. In contrast, a significant difference in seasonal distribution among decedents exhibiting cardiac structural abnormalities at the post-mortem examination (n=1841) was observed. In this subgroup, SCDs occurred more frequently during winter (27 %) compared to summer (22%) (p=0.007). In cases diagnosed with a myocardial disease (n=1399), SCD was most common during the winter (27%) and least common during the summer (22%) (p=0.027).

Conclusions

While SADS occurs throughout the year with no seasonal variation, SCD due to structural heart disease appears to be more common during the winter. Bio-meteorological factors may be potential triggers of SCD in individuals with an underlying structural cardiac abnormality.

中文翻译：

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心脏性猝死的季节性变化：来自英国大型登记处的见解

背景

心源性猝死 (SCD) 相对常见，可能发生在表面健康的个体中。人们对季节性变化作为 SCD 危险因素的作用知之甚少。本研究的目的是调查 SCD 是否表现出对特定季节的偏好。

方法

我们回顾了 2000 年至 2018 年间转诊至伦敦圣乔治大学心脏病学中心的 4751 例 SCD 病例（平均年龄 38 ± 17 岁）的数据库。临床信息来自转诊验尸官，他们被要求填写一份详细的调查问卷。所有病例均由心脏病病理学家专家对心脏进行宏观和组织学评估。

结果

SCD 在冬季更为常见 (26%)，在夏季较少见 (24%)，p= 0.161。在心脏结构正常的心律失常性猝死综合征（SADS，2910 例）病例中未观察到显着的季节性变化。相比之下，在死后检查时表现出心脏结构异常的死者（n = 1841）中观察到季节性分布存在显着差异。在该亚组中，SCD 在冬季 (27%) 发生的频率高于夏季 (22%) (p=0.007)。在诊断患有心肌疾病的病例 (n=1399) 中，SCD 在冬季最常见 (27%)，在夏季最不常见 (22%) (p=0.027)。

结论

虽然 SADS 全年都会发生，没有季节性变化，但结构性心脏病引起的 SCD 似乎在冬季更为常见。对于具有潜在结构性心脏异常的个体，生物气象因素可能是 SCD 的潜在触发因素。