Erin B Wasserman1, Wojciech Zareba2, Mark J Utell3, David Oakes4, Philip K Hopke5, Mark Frampton3, David Chalupa3, William Beckett6, David Q Rich1. 1. Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, 265 Crittenden Boulevard, CU420644, Rochester, NY 14642. 2. Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, 265 Crittenden Boulevard, Rochester, NY 14642. 3. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 692, Rochester, NY 14642. 4. Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Box 630, Rochester, NY 14642. 5. Department of Chemical and Biomolecular Engineering, Clarkson University, PO Box 5708, Potsdam, NY 13699-5708. 6. Department of Medicine, Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02138.
Abstract
BACKGROUND: Both increases and decreases in ambient temperature have been associated with increased cardiovascular mortality and morbidity. However, the mechanism(s) remain unclear. OBJECTIVES: We examined associations between biomarkers of pathways thought to, in part, explain these associations and changes in ambient temperature in a panel of predominantly post-myocardial infarction or post-stent patients. METHODS: We studied 76 subjects who had a recent coronary event and were participating in a cardiac rehabilitation program. In these patients, we measured heart rate variability, repolarization, and baroreflex sensitivity parameters using Holter ECG recordings before and during supervised, graded, twice weekly, exercise sessions. Hourly temperature measurements were made at a monitoring site near the rehabilitation center. RESULTS: Using linear mixed models, we observed decreases in rMSSD (square root of the mean of the sum of the squared differences between adjacent NN intervals) and deceleration capacity, associated with increases in ambient temperature in the previous four days. Additionally, decreased rMSSD was associated with both increasing temperature (mean in previous 6 hours) in the summer and decreasing temperature (mean in the previous 3 weeks) in the winter. CONCLUSIONS: In a panel of cardiac rehabilitation patients, changes in ambient temperature were associated with decreases in markers of heart rate variability and baroreflex sensitivity, which may lead to increased risk of arrhythmic events and sudden death in post-infarction patients.
BACKGROUND: Both increases and decreases in ambient temperature have been associated with increased cardiovascular mortality and morbidity. However, the mechanism(s) remain unclear. OBJECTIVES: We examined associations between biomarkers of pathways thought to, in part, explain these associations and changes in ambient temperature in a panel of predominantly post-myocardial infarction or post-stent patients. METHODS: We studied 76 subjects who had a recent coronary event and were participating in a cardiac rehabilitation program. In these patients, we measured heart rate variability, repolarization, and baroreflex sensitivity parameters using Holter ECG recordings before and during supervised, graded, twice weekly, exercise sessions. Hourly temperature measurements were made at a monitoring site near the rehabilitation center. RESULTS: Using linear mixed models, we observed decreases in rMSSD (square root of the mean of the sum of the squared differences between adjacent NN intervals) and deceleration capacity, associated with increases in ambient temperature in the previous four days. Additionally, decreased rMSSD was associated with both increasing temperature (mean in previous 6 hours) in the summer and decreasing temperature (mean in the previous 3 weeks) in the winter. CONCLUSIONS: In a panel of cardiac rehabilitation patients, changes in ambient temperature were associated with decreases in markers of heart rate variability and baroreflex sensitivity, which may lead to increased risk of arrhythmic events and sudden death in post-infarctionpatients.
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