Skip to main content
SpringerLink
Log in

Seasonal variation in patients with acute heart failure: prognostic impact of admission in the summer

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

There have been few reports discussing the clinical significance of the season of admission of acute heart failure (AHF) patients. The data of 661 patients with AHF admitted to the intensive care unit were analyzed. Patients were assigned to a summer admission (Group-S, n = 113, between July and September), a winter admission (Group-W, n = 214, between December and February), or to the other seasons admission group (Group-O, n = 334). We evaluated the relationships between the seasonal variations and the clinical profiles, and the long-term prognosis. There were significantly more patients with cardiomyopathy and New York Heart Association class 4, and the serum levels of total bilirubin were significantly higher in Group-S (85.8, 24.8 %, and 0.60 [0.50–0.90]) than in Group-W (75.2, 15.4 %, and 0.60 [0.40–0.78]). The left ventricular ejection fraction on admission was significantly reduced and intravenous administration of dobutamine was used more frequently in Group-S (30.0 [25.0–46.0], 31.9 %) than in Group-W (34.4 [25.2–48.0], 20.6 %) and Group-O (35.0 [25.0–46.0], 19.8 %). The multivariate Cox regression model found that summer admission was independently associated with cardiovascular death (HR: 1.58, 95 % CI 1.01–2.48; p = 0.044) and heart failure (HF) events (HR: 1.55, 95 % CI 1.05–2.28; p = 0.028). The Kaplan–Meier curves showed that the cardiovascular death rate was significantly higher in Group-S than in Group-W and Group-O, and the HF events were significantly higher in Group-S than in Group-O. The summer admission AHF patients included sicker patients, and the prognosis in these patients was worse than in the patients admitted at other times.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ornato JP, Peberdy MA, Chandra NC, Bush DE (1996) Seasonal pattern of acute myocardial infarction in the national registry of myocardial infarction. J Am Coll Cardiol 7:1684–1688

    Article  Google Scholar 

  2. Manfredini R, Gallerani M, Boari B, Salmi R, Mehta RH (2004) Seasonal variation in onset of pulmonary embolism is independent of patients’ underlying risk comorbid conditions. Clin Appl Thromb Hemost 10:39–43

    Article  CAS  PubMed  Google Scholar 

  3. Manfredini R, Boari B, Manfredini F, Salmi R, Bossone E, Fabbri D, Contato E, Mascoli F, Gallerani M (2008) Seasonal variation in occurrence of aortic diseases: the database of hospital discharge data of the Emilia-Romagna region, Italy. J Thorac Cardiovasc Surg 135:442–444

    Article  PubMed  Google Scholar 

  4. Arntz HR, Willich SN, Schreiber C, Brüggemann T, Stern R, Schultheiss HP (2000) Diurnal, weekly and seasonal variation of sudden death. Population-based analysis of 24,061 consecutive cases. Eur Heart J 21:315–320

    Article  CAS  PubMed  Google Scholar 

  5. Stewart S, McIntyre K, Capewell S, McMurray JJ (2002) Heart failure in a cold climate. Seasonal variation in heart failure-related morbidity and mortality. J Am Coll Cardiol 39:760–766

    Article  PubMed  Google Scholar 

  6. Feldman DE, Platt R, Déry V, Kapetanakis C, Lamontagne D, Ducharme A, Giannetti N, Frenette M, Beck EJ (2004) Seasonal congestive heart failure mortality and hospitalisation trends, Quebec 1990–1998. J Epidemiol Community Health 58:129–130

    Article  PubMed  Google Scholar 

  7. Boulay F, Berthier F, Sisteron O, Gendreike Y, Gibelin P (1999) Seasonal variation in chronic heart failure hospitalizations and mortality in France. Circulation 100:280–286

    Article  CAS  PubMed  Google Scholar 

  8. Inglis SC, Clark RA, Shakib S, Wong DT, Molaee P, Wilkinson D, Stewart S (2008) Hot summers and heart failure: seasonal variations in morbidity and mortality in Australian heart failure patients (1994–2005). Eur J Heart Fail 10:540–549

    Article  PubMed  Google Scholar 

  9. Díaz A, Ferrante D, Badra R, Morales I, Becerra A, Varini S, Nul D, Grancelli H, Doval H (2007) Seasonal variation and trends in heart failure morbidity and mortality in a South American community hospital. Congest Heart Fail 13:263–266

    Article  PubMed  Google Scholar 

  10. Gallerani M, Boari B, Manfredini F, Manfredini R (2011) Seasonal variation in heart failure hospitalization. Clin Cardiol 34:389–394

    Article  PubMed  Google Scholar 

  11. Gotsman I, Zwas D, Admon D, Lotan C, Keren A (2010) Seasonal variation in hospital admission in patients with heart failure and its effect on prognosis. Cardiology 117:268–274

    Article  PubMed  Google Scholar 

  12. Ogawa M, Tanaka F, Onoda T, Ohsawa M, Itai K, Sakai T, Okayama A, Nakamura M (2007) Northern Iwate Heart Disease Registry Consortium. A community based epidemiological and clinical study of hospitalization of patients with congestive heart failure in Northern Iwate, Japan. Circ J 71:455–459

    Article  PubMed  Google Scholar 

  13. Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, Strömberg A, van Veldhuisen DJ, Atar D, Hoes AW, Keren A, Mebazaa A, Nieminen M, Priori SG, Swedberg K, ESC Committee for Practice Guidelines (CPG) (2008) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J 29: 2388–2442

    Google Scholar 

  14. Nieminen MS, Harjola VP (2005) Definition and epidemiology of acute heart failure syndromes. Am J Cardiol 96:5G–10G

    Article  PubMed  Google Scholar 

  15. Mebazaa A, Gheorghiade M, Pina IL, Harjola VP, Hollenberg SM, Follath F, Rhodes A, Plaisance P, Roland E, Nieminen M, Komajda M, Parkhomenko A, Masip J, Zannad F, Filippatos G (2008) Practical recommendations for prehospital and early in-hospital management of patients presenting with acute heart failure syndromes. Crit Care Med 36:S129–S139

    Article  PubMed  Google Scholar 

  16. Gheorghiade M, Zannad F, Sopko G, Klein L, Piña IL, Konstam MA, Massie BM, Roland E, Targum S, Collins SP, Filippatos G, Tavazzi L (2005) Acute heart failure syndromes: current state and framework for future research. Circulation 112:3958–3968

    Article  PubMed  Google Scholar 

  17. Matsushita M, Shirakabe A, Hata N, Shinada T, Kobayashi N, Tomita K, Tsurumi M, Shimura T, Okazaki H, Yamamoto Y, Yokoyama S, Asai K, Mizuno K (2013) Association between the visiting time and the clinical findings on admission in patients with acute heart failure. J Cardiol 61:210–215

    Article  PubMed  Google Scholar 

  18. Hamaguchi S, Kinugawa S, Tsuchihashi-Makaya M, Goto D, Tsutsui H (2013) Weekend versus weekday hospital admission and outcomes during hospitalization for patients due to worsening heart failure: a report from Japanese cardiac registry of heart failure in cardiology (JCARE-CARD). Heart Vessels. doi:10.1007/s00380-013-0359-5

    PubMed  Google Scholar 

  19. Keatinge WR, McIlroy MB, Goldfien A (1964) Cardiovascular responses to ice-cold showers. J Appl Physiol 19:1145–1150

    CAS  PubMed  Google Scholar 

  20. Westheim A, Os I, Thaulow E, Kjeldsen SE, Eritsland J, Eide IK (1992) Haemodynamic and neurohumoral effects of cold pressor test in severe heart failure. Clin Physiol 12:95–106

    Article  CAS  PubMed  Google Scholar 

  21. Hayward JM, Holmes WF, Gooden BA (1976) Cardiovascular responses in man to a stream of cold air. Cardiovasc Res 10:691–696

    Article  CAS  PubMed  Google Scholar 

  22. Argilés A, Mourad G, Mion C (1998) Seasonal changes in blood pressure in patients with end-stage renal disease treated with hemodialysis. N Engl J Med 339:1364–1370

    Article  PubMed  Google Scholar 

  23. Gorman S, Hart PH (2012) The current state of play of rodent models to study the role of vitamin D in UV-induced immunomodulation. Photochem Photobiol Sci 11:1788–1796

    Article  CAS  PubMed  Google Scholar 

  24. Barnett AG, de Looper M, Fraser JF (2008) The seasonality in heart failure deaths and total cardiovascular deaths. Aust N Z J Public Health 32:408–413

    Article  PubMed  Google Scholar 

  25. Brennan PJ, Greenberg G, Miall WE, Thompson SG (1982) Seasonal variation in arterial blood pressure. BMJ 285:919–923

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Iwaya S, Yoshihisa A, Nodera M, Owada T, Yamada S, Sato T, Suzuki S, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh S-i, Takeishi Y (2013) Suppressive effects of adaptive servo-ventilation on ventricular premature complexes with attenuation of sympathetic nervous activity in heart failure patients with sleep-disordered breathing. Heart Vessel. doi:10.1007/s00380-013-0394-2

  27. Hori M, Nagai R, Izumi T, Matsuzaki M (2013) Efficacy and safety of bisoprolol fumarate compared with carvedilol in Japanese patients with chronic heart failure: results of the randomized, controlled, double-blind, multistep administration of bisoprolol in chronic heart failure II (MAIN-CHF II) study. Heart Vessel. doi:10.1007/s00380-013-0340-3

  28. Hattori H, Minami Y, Mizuno M, Yumino D, Hoshi H, Arashi H, Nuki T, Sashida Y, Higashitani M, Serizawa N, Yamada N, Yamaguchi J, Mori F, Shiga T, Hagiwara N (2013) Differences in hemodynamic responses between intravenous carperitide and nicorandil in patients with acute heart failure syndromes. Heart Vessel 28:345–351

    Article  Google Scholar 

  29. Shirakabe A, Hata N, Yokoyama S, Shinada T, Kobayashi N, Asai K, Mizuno K (2010) Efficacy and safety of nicorandil therapy in patients with acute heart failure. J Cardiol 56:339–347

    Article  PubMed  Google Scholar 

  30. Shirakabe A, Hata N, Yokoyama S, Shinada T, Kobayashi N, Tomita K, Kitamura M, Nozaki A, Tokuyama H, Asai K, Mizuno K (2011) Predicting the success of noninvasive positive pressure ventilation in emergency room for patients with acute heart failure. J Cardiol 57:107–114

    Article  PubMed  Google Scholar 

  31. Hata N, Seino Y, Tsutamoto T, Hiramitsu S, Kaneko N, Yoshikawa T, Yokoyama H, Tanaka K, Mizuno K, Nejima J, Kinoshita M (2008) Effects of carperitide on the long-term prognosis of patients with acute decompensated chronic heart failure: the PROTECT multicenter randomized controlled study. Circ J 72:1787–1793

    Article  CAS  PubMed  Google Scholar 

  32. Oktay C, Luk JH, Allegra JR, Kusoglu L (2009) The effect of temperature on illness severity in emergency department congestive heart failure patients. Ann Acad Med Singap 38:1081–1084

    PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to the staff of the ICU and the medical records office at Chiba Hokusoh Hospital, Nippon Medical School, for their valuable assistance in collecting the medical data.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Division of Intensive Care Unit (ICU), Chiba Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan

    Yoshiya Yamamoto, Akihiro Shirakabe, Noritake Hata, Nobuaki Kobayashi, Takuro Shinada, Kazunori Tomita, Masanori Yamamoto, Masafumi Tsurumi, Masato Matsushita, Hirotake Okazaki & Shinya Yokoyama

  2. Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan

    Kuniya Asai, Kyoichi Mizuno & Wataru Shimizu

Authors
  1. Yoshiya Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Akihiro Shirakabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Noritake Hata
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nobuaki Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takuro Shinada
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kazunori Tomita
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masanori Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masafumi Tsurumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Masato Matsushita
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hirotake Okazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shinya Yokoyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Kuniya Asai
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Kyoichi Mizuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Wataru Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akihiro Shirakabe.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamamoto, Y., Shirakabe, A., Hata, N. et al. Seasonal variation in patients with acute heart failure: prognostic impact of admission in the summer. Heart Vessels 30, 193–203 (2015). https://doi.org/10.1007/s00380-013-0461-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-013-0461-8

Keywords

Search

Navigation