Circadian, weekly, seasonal, and temperature-dependent patterns of syncope aetiology in patients at increased risk of cardiac syncope
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Circadian, weekly, seasonal, and temperature-dependent patterns of syncope aetiology in patients at increased risk of cardiac syncope. / du Fay de Lavallaz, Jeanne; Badertscher, Patrick; Nestelberger, Thomas; Flores, Dayana; Miró, Òscar; Salgado, Emilio; Geigy, Nicolas; Christ, Michael; Cullen, Louise; Than, Martin; Martin-Sanchez, F Javier; Rodriguez-Adrada, Esther; Di Somma, Salvatore; Peacock, W Frank; Kawecki, Damian; Boeddinghaus, Jasper; Twerenbold, Raphael; Puelacher, Christian; Wussler, Desiree; Strebel, Ivo; Keller, Dagmar I; Poepping, Imke; Kühne, Michael; Reichlin, Tobias; Mueller, Christian; BASEL IX Investigators.
In: EUROPACE, Vol. 21, No. 3, 01.03.2019, p. 511-521.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Circadian, weekly, seasonal, and temperature-dependent patterns of syncope aetiology in patients at increased risk of cardiac syncope
AU - du Fay de Lavallaz, Jeanne
AU - Badertscher, Patrick
AU - Nestelberger, Thomas
AU - Flores, Dayana
AU - Miró, Òscar
AU - Salgado, Emilio
AU - Geigy, Nicolas
AU - Christ, Michael
AU - Cullen, Louise
AU - Than, Martin
AU - Martin-Sanchez, F Javier
AU - Rodriguez-Adrada, Esther
AU - Di Somma, Salvatore
AU - Peacock, W Frank
AU - Kawecki, Damian
AU - Boeddinghaus, Jasper
AU - Twerenbold, Raphael
AU - Puelacher, Christian
AU - Wussler, Desiree
AU - Strebel, Ivo
AU - Keller, Dagmar I
AU - Poepping, Imke
AU - Kühne, Michael
AU - Reichlin, Tobias
AU - Mueller, Christian
AU - BASEL IX Investigators
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - AIMS: It is unknown whether cardiac syncope, and possibly also other syncope aetiologies exhibit circadian, weekly, seasonal, and temperature-dependent patterns.METHODS AND RESULTS: We prospectively recorded the exact time, date, and outside temperature of syncope of patients >40 years old presenting with syncope to the emergency department in a diagnostic multicentre study. Two independent cardiologists/emergency physicians adjudicated the final diagnosis based on all information becoming available during clinical work-up including 1-year follow-up. Among 1230 patients, the adjudicated aetiology was cardiac in 14.6%, reflex in 39.2%, orthostatic in 25.7%, other non-cardiac in 9.7%, and unknown in 10.8% of patients. All syncope aetiologies occurred much more frequently during the day when compared with the night (P < 0.01). While reflex and orthostatic syncope showed a broad peak of prevalence with 80.9% of these events occurring between 4 am and 4 pm, cardiac syncope showed a narrow peak of prevalence with 70.1% of all events occurring between 8 am and 2 pm. A weekly pattern was present for most syncope aetiologies, with events occurring mainly from Monday to Friday (P < 0.01). Reflex syncope displayed a seasonal rhythm and was more common in winter (P < 0.01), while cardiac syncope stayed constant over the year. Syncope occurred most often when the outside temperature was coldest. Overall the patterns observed for cardiac syncope were similar to the patterns observed for its differential diagnosis.CONCLUSION: Syncope aetiologies in patients >40 years old display circadian, weekly, seasonal, and temperature-dependent patterns. Unfortunately, these patterns do not allow to reliably differentiate cardiac syncope from other aetiologies.
AB - AIMS: It is unknown whether cardiac syncope, and possibly also other syncope aetiologies exhibit circadian, weekly, seasonal, and temperature-dependent patterns.METHODS AND RESULTS: We prospectively recorded the exact time, date, and outside temperature of syncope of patients >40 years old presenting with syncope to the emergency department in a diagnostic multicentre study. Two independent cardiologists/emergency physicians adjudicated the final diagnosis based on all information becoming available during clinical work-up including 1-year follow-up. Among 1230 patients, the adjudicated aetiology was cardiac in 14.6%, reflex in 39.2%, orthostatic in 25.7%, other non-cardiac in 9.7%, and unknown in 10.8% of patients. All syncope aetiologies occurred much more frequently during the day when compared with the night (P < 0.01). While reflex and orthostatic syncope showed a broad peak of prevalence with 80.9% of these events occurring between 4 am and 4 pm, cardiac syncope showed a narrow peak of prevalence with 70.1% of all events occurring between 8 am and 2 pm. A weekly pattern was present for most syncope aetiologies, with events occurring mainly from Monday to Friday (P < 0.01). Reflex syncope displayed a seasonal rhythm and was more common in winter (P < 0.01), while cardiac syncope stayed constant over the year. Syncope occurred most often when the outside temperature was coldest. Overall the patterns observed for cardiac syncope were similar to the patterns observed for its differential diagnosis.CONCLUSION: Syncope aetiologies in patients >40 years old display circadian, weekly, seasonal, and temperature-dependent patterns. Unfortunately, these patterns do not allow to reliably differentiate cardiac syncope from other aetiologies.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Australia/epidemiology
KW - Circadian Rhythm
KW - Europe/epidemiology
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - New Zealand/epidemiology
KW - Prevalence
KW - Prospective Studies
KW - Risk Factors
KW - Seasons
KW - Syncope/diagnosis
KW - Temperature
KW - Time Factors
KW - United States/epidemiology
U2 - 10.1093/europace/euy186
DO - 10.1093/europace/euy186
M3 - SCORING: Journal article
C2 - 30137300
VL - 21
SP - 511
EP - 521
JO - EUROPACE
JF - EUROPACE
SN - 1099-5129
IS - 3
ER -
