1. Coronary heart disease and solar activity (the new data) Dr. Yury I. Gurfinkel M.D., Dr. of Med. Sc. Central Clinical Hospital, JSC “Russian Railways” and Space Research Institute, Russian Academy of Sciences yugurf@aha.ru 2007

2. Investigations of responsible mechanism of this influence on living objects were began by Alexander Tchijevsky in Russia. Tchijevsky (1927) compared epidemic diseases, sudden cardiac death with solar activity and showed its correlations with Conrad Wolf`s number of sunspots. Similar influence of solar activity on acute cardiological pathology demonstrated by M.Faure and G.Sardou in France (1927), B. and C.Dull in Germany (1937). Physical- chemical approach started already in early sixties by G.Piccardi and was based on sensitivity of water to low level of energy of physical factors existing and fluctuating in environment.

3. Patients and method: the body of data on acute cardiovascular and cerebral pathology in seven medical independent centers was analyzed. The longest period of observation was 14 years. Cases when it was not possible to establish exact dates of disease were excluded from analysis! The total of a myocardial infarction cases amounted, and The total of a myocardial infarction cases amounted 10390, and for brain stroke -. for brain stroke - 15660. Magnetic activities data was provided by the IZMIRAN Magnetic laboratory (Troitsk, Moscow Region) and processed using the imposed epoch method [Mustel, 1968]. The goal of investigation to provide statistical evidence of geomagnetic influence on the rate of acute cardiovascular and cerebral pathologies

4. Date January 1999 Myocardial infarction Brain stroke Myocardial infarction Total BrainstrokeTotal mailfemalemailfemalemailfemalemailfemale 01 02 03 04 ….. The template for collecting data for one month This is the template for collecting data for one month. It is very important to collect patients with precisely established date of diseases (but not a date of admission). to collect patients with precisely established date of diseases (but not a date of admission). Patients with unknown date of diseases should be excluded from study. It is very important. Also it should be excluded all cases when diseases or death were as a result of surgery or an interventional methods (for example angiography or coronary angioplasty). or an interventional methods (for example angiography or coronary angioplasty).

5. biotropic coefficient k бc =  МА/  МQ biotropic coefficient k бc =  МА/  МQ  Average numbers of patients on a active and quiet days were compared. Biotropic coefficient as a quantitative measure of frequency of cardiovascular diseases as a function of geomagnetic activity calculated for myocardial infarction and brain stroke The information of the geomagnetic data provided by the IZMIRAN Magnetic laboratory (Troitsk, Moscow Region) and processed using the imposed epoch method [Mustel, 1968].

6. Parameters years The sum for all period 1992199319941995199619971998199920002001 Total amount of cases691161171169688611088685942 Diurnal average number of patients, in active days Diurnal average number of patients, in active days, N 124373627131312253421242 Duration of active period, days 57858758343148738653612 Diurnal average number of patients, in quiet days Diurnal average number of patients, in quiet days, N 245798189837549835264700 Duration of quiet period, days 3092802783073323343172922803123041 Diurnal average number of patients, in one active day Diurnal average number of patients, in one active day  МА, patients/day0,420,440,410,470,390,420,250,340,400,400,40 Diurnal average number of patients, in one quiet day Diurnal average number of patients, in one quiet day  МQ, patients/day0,150,280,290,290,250,220,150,280,190,200,23 Biotropic coefficient k бт =  МА/  М Q 2,871,541,421,601,541,891,621,202,142,01,73 The biotropic coefficient for brain strokes patients in Central Clinical Hospital for 1992-2001 years

7. HOSPITALS THE PERIOD OF OBSERVATIONMYOCARDIAL INFARCTION INFARCTION (quantity of cases) BRAIN STROCK (quantity of cases) К bt forMYOCARDIALINFARCTION BRAIN STROCK Central clinical hospital, Ministry of Railway Transportation (Moscow) 12 years (1992-2003гг.) 144011082,07 1,96 Clinical hospital Russian Academy of Science (Troitzk, Moscow region) 5 years (1999-2003гг.) 342256 1,90 2,03 Hospital for War veterans (Moscow) 7 years (1995-2001гг.) 1747  1,69  City urgent hospital (Batumi, Georgia) 3,5 years (2000-2003гг.) 48113511,93 2,08 City and regional hospitals (Kalinigrad, Russia) 1,5 years (2002-2003гг.) 63019402,402,10 City hospital St.-Petersburg 4 years (2001-2004 гг) 519159422.02,01 Benxi city hospital(China) 3-7 years 1999-2005 559Years2003-2005 5063 Years 1999-20051.782.05

8.  It was shown statistically that during geomagnetic disturbances the frequency of myocardial infarction and brain stroke cases increased on the average twice in comparison with geomagnetic quite condition.  New results of seven data sources confirm results of our previous investigation.  The cause of hospitals high К bt in comparison with ambulance К bt probably depends on additional possibilities for accurate laboratory and functional diagnostics in hospitals then in ambulance.

9. The investigation is in a progress Every hospital in any region of the world can join with own data to general statistics using similar format for its collecting

10. What is a pathway responsible for worsening patients suffering with CAD at the solar activity increasing?

11. Based on data of Belinson Medical Center (Israel) E.Stoupel (1980) concluded that geomagnetic disturbances increased the blood viscosity, coagulation and platelets aggregation. This observation made significant reasons for study capillary blood flow in patients with coronary heart disease (CHD) because transcapillary exchange is very important for maintaining vital function of organs and tissues. This observation made significant reasons for study capillary blood flow in patients with coronary heart disease (CHD) because transcapillary exchange is very important for maintaining vital function of organs and tissues.

12. The appearance of new computer technologies and resources of programming allowed developing a computer capillaroscope for non-invasive measurement of the capillary diameters, blood flow velocity as well as the perivascular area size and the number of the blood aggregates Microcirculation study

13. Cross-section of skin Scaly cells Capillares

15. Perivascular zone size

16. Capillary blood flow in healthy volunteer Х 550

17. Portable computer capillaroscopes for monitoring parameters of microcirculation

18. Patients and methods  Microcirculation in capillaries studied in the cuticle above the nail using vital noninvasive capillaroscopy with 550-fold magnification. A total of 144 CAD patients (89 men and 55 women) were tested during 10-14 days at fixed time and ambient temperature. Microcirculation daily data compared with daily values of the local geomagnetic A-index, obtained from Geomagnetic Observatory (IZMIRAN, Troitzk, Moscow region)

19. The patient with CAD, 53 years One day before geomagnetic storm Х 550

20. The same patient next day after beginning of geomagnetic storm Х 550 (erythrocyte aggregates in the blood)

21.  The investigation of capillary blood flow in patients with coronary heart disease (CHD) revealed a high dependence between capillary flow and geomagnetic activity On the first days of geomagnetic storms, pathological changes of microcirculation parameters were detected in 68.5% CHD patients. On the second days of geomagnetic storms, pathological changes of microcirculation parameters increased more and amount to 90,2 % in CHD patients. The reaction of healthy volunteers on geomagnetic disturbances was not statistically significant for whole group. However, some of them reacted to the geomagnetic disturbances by microcirculation disorders.

22. диплом

23. Parallel study of geomagnetic influence on 32 patients with coronary heart disease on subjective - psychophysical and intellectual parameterson subjective - psychophysical and intellectual parameters on frequency of pulse and arterial blood pressureon frequency of pulse and arterial blood pressure on parameters of microcirculationon parameters of microcirculation on results of 24-hour ECG monitoringon results of 24-hour ECG monitoring on parameters of a hemostasison parameters of a hemostasis Parameters N = 32 Patients with angina pectoris Patients with myocardial infarction n=22 %* n=10 %* Arterial hypertension 1254660 Postinfarction cardiosclerosis 945550 Diabetes Insulin ( +) Insulin ( -) 14,51111 20 Heart failure FC-1 NYHA) FC-2 NYHA) FC-2 FC-3 FC-3 Total Total 7 4 1 12 5453195319 90 Disorders of heart rhythm 1359770 The characteristic of patients * Percentage in group

24. BP capillary flow ECG 24-h PhEIPulsesysdya Disorders of heart rhythmSTBCTPlateletsaggregation parameters 77777777744 0445566--4611 133211141123 2------1----32--1-- 3---------------------- Evaluation of results by each techniques at 7 healthy volunteers revealed at quiet and active geomagnetic conditions Ph - physical activity ; E - emotional condition ; I -intellectual activity ; BP(sys, dia) – blood pressure (systolic, diastolic ); CF- capillary flow; BCT – Blood coagulation test; PLT. –platelets 0 - absence of any shifts of parameters 1 - small shifts of parameters 2 - significant shifts of parameters 3 – very significant shifts of parameters

25. PhEIpulse BP at 13.00 CF ECG 24-h BP-24-hours PLT BCT platelets aggregation SysDya Disorde rs of heart rhythmSTSysDia parameters323232292929232622551088 01722291716221111256-2 11193910414833--353 231--333797--------- 31----------171---133 Evaluation of results by each technique in CHD patients revealed at quiet and active geomagnetic conditions Ph - physical activity ; E - emotional condition ; I -intellectual activity ; BP(sys, dia) – blood pressure (systolic, diastolic ); CF- capillary flow; BCT – Blood coagulation test; PLT –platelets 0 - absence of any shifts of parameters 1 - small shifts of parameters 2 - significant shifts of parameters 3 – very significant shifts of parameters

26. Holter 24-houre EKG-monitoring of CHD-patient during geomagnetic storms Кольский полуостров, 31.03. 2001, 23 UT фото С.Черноус, Н.Белишевой

27. platelet aggregation and blood coagulation in patients suffering with CHD  We followed up 75 patients: 48 men (56 ± 8 years) and 27 women (60 ± 5 years) using platelet aggregometers TROMLITE-1006A" (Russia-Germany) and "CHRONOLOG" (USA); as an inducer of platelet aggregation was used adenosine diphosphate (ADP). Blood sampling performed between 9-10 h AM on days with quiet and increased geomagnetic activity.  Results: The maximal rate of platelet aggregation (Vмакс) had increased on active days in 77,3 % of patients in comparison with quiet geomagnetic conditions, the degree of aggregation (Ат) had increased in 88 % of patients. Time of aggregation (Тагр) has decreased in 74 % of all patients. Thus, this test showed high sensitivity of patients to geomagnetic disturbances.  Blood sampling for coagulation test accomplished simultaneously with blood sampling for platelet aggregation also in 75 patients. Graphical registration of blood clot formation and change of its consistence in time carried out using “Trombelastograph” (Russia).  Significant change revealed in 82 % of patients only for time from the moment of blood sampling to the beginning of formation of a clot. Other parameters of the coagulation test did not changed significantly.

28. Parameters Patients with angina pect. Patients without angina pect. Total amount in group% in group Total amount in group% in group Men (56 ± 8 ) 3459,614 77,7 Women (60 ± 5) 2340,44 22,3 total in group 57 76 * 18 24 * Arterial hypertensia 3154,3527,7 Postinfarction cardiosclerosis 2442,1633,3 Diabetes 1119,215,5 Heart failure 2543,8527,7 Disorders of heart rhythm 1119,21266,5 * percentage from total of patients (n=75) The comparative clinical characteristic of patients (n=75) The influence of geomagnetic activity on platelets aggregation, blood coagulation, microcirculation in patients suffering with CHD

29. R - time of reaction - time from a blood sampling to the beginning of clot formation - characterizes process of thromboplastin formation and prothrombin transformation into thrombin (p <0.01 ) К - время коагуляции - от конца R до образования сгустка определённой (условной) плотности, в нашем случае соответствует амплитуде 10 мм, - характеризует скорость образования фибрина. S - Индекс Синереза - от конца R до образования сгустка наибольшей прочности - характеризует скорость образования фибрина, его ретракции. Т - общее время формирования сгустка - от забора крови до максимальной амплитуды - показывает интенсивность формирования сгустка и общее время ретракции. Ам - максимальная амплитуда - определяется прочностью кровяного сгустка. Blood coagulation in quiet and active geomagnetic conditions in 75 CHD patients Т (min) Ам (мм) 10 мм К R R (min) S blood sampling quiet active

30. Vмаx - the maximal speed of aggregation - characterizes speed of platelets activation and primary aggregation in seconds Ат - degree of aggregation – quantity of platelets entered reaction of aggregation in percentage Т аgg - time before the maximal aggregation (time of aggregation) in seconds in 75 CAD patients Platelets aggregation study in 75 CAD patients Ат % Т аgg.(s) V маx. %/s Introduction Inductor of aggregation s Quiet Activ Differences (М ±m) % Difference % Vмакс Vмакс (%/s) n=75 1,081,22 0,14 ± 0,03 p < 0.01 12,9 n=14 During MS1.091.31 0,22±0.04 0,22±0.04 p < 0.01 p < 0.0120.1 Ат Ат (%) n=75 6169 8 ± 1 p < 0.02 13,1 n=14 During MS6277 15 ± 2 p < 0.05 24 Таgg Таgg (s) n=75 253234 -19 ± 5 p < 0.02 7,6 n=14 During MS 249238 -11 ± 4 p < 0.05 6 Platelets are a key component in the process of thrombus formation

31. (PWV) (ED) endothelial dysfunction (PWV) pulse wave velocity (ED) endothelial dysfunction  Interest in, and measurement of, the velocity of arterial wave propagation as an index of vascular stiffness and vascular health dates back to the early part of the last century. The endothelium has a powerful effect on blood vessel tone and regulates blood flow, adjusts coagulation and blood thickening, and secretes chemicals and other substances in response to wounds, infections or irritation. It also plays an important role in the development of cardiovascular disease.  Using specially designed device (AMDT, Russia) for noninvasive evaluation of pulse wave velocity (PWV) and endothelial dysfunction, we performed pilot study for understanding possible influence of geomagnetic activity on PWV and ED. Obtained results, suggested that during active geomagnetic conditions this parameters of vascular system can change significantly.  Preliminary researches of an endothelial function allows to estimate quantitatively a condition of sympathoadrenal systems at the moment of research.  Thus, for the first time there is an opportunity to estimate in dynamics reaction sympathoadrenal system on influence of environmental factors.

32. Ultrasound examination of blood flow and endothelial function on brachial and radial arteries before and after standard hyperemia test.

33. Device for pulse wave velocity and endotelial function measurement

34. Measurement of pulse wave velocity

41. The ESR-graphy of blood of 13 patients with CHD (9 women, 48-83 years old, and 4 men, 63-83 years old) and two healthy volunteers (54 and 55 years old) was performed on at least 2 different days with different geomagnetic activity for each case. All the patients were examined within 10 days after a heart attack. Myocardial infarction was confirmed in 11 patients. The blood was sampling by venous or finger puncture and stabilized with 3,2% sodium citrate (9:1). In parallel experiments with venous or finger blood of the same donor no significant differences in blood behavior was noted. The stabilized blood was used within 2 hours after the extraction. The blood was placed into glass pipettes with an internal diameter of 1±0,1 mm to make a 100 mm high blood column. The pipettes were fixed in special holders in which the bottom opening of the capillary was tightly closed. The holders were placed into the device for multi-channel high temporal resolution of blood sedimentation rate, the “ESR scan” Schematic of the ESR scan (1) light source, (2) the stand at which pipettes filled with blood (1) light source, (2) the stand at which pipettes filled with blood (3) are fixed, (4) the lens, (3) are fixed, (4) the lens, (5), (6) elements of light detecting and scanning system, (7) ambient light protecting case, (8) PC.

42. ESR plots showing the change in the position of the boundary between the red blood and the plasma on 4 different days for patient with CHD. Color plot is the day of a geomagnetic storm (30.01.99)

43. Discussion  Our experimental studies indicate that geomagnetic activities influence on blood and vessels of CHD patients. The revealed disorders could suggest an essential role of blood in magnetoreception.  Red blood cells (RBS) are extremely sensitive to electromagnetic forces. Their ability to adsorb and process light provides a means for transmitting and integrating light and magnetic information. RBCs are plausibly the cells that transmit the information collected to the pineal and perhaps elsewhere in the brain and in the heart via biophotonic emission (Dillon, 2003, Gurfinkel, 2004).  We suggest that geomagnetic fluctuations acting on blood, brain, adrenals involve the adaptation system. This leads to the appearance in blood adrenals hormones that responsible for activation of the clotting system, rise in aggregation and spasm in the afferent vessels of the microcirculatory network. In persons suffering from CHD, the foreground problem is the reversibility of these pathological processes.

44. ГЕОМАГНИТНОЕ ВОЗМУЩЕНИЕ Магниторецепторы мозга Гипоталамус + катехоламины Повышенный выброс гормонов надпочечников Повышение общего периферического сопротивления Повышение артериального давления Дополнительная нагрузка на миокард Нарушения сердечного ритма Фатальные аритмии Тканевые магниторецепторы Дестабилизация ионных насосов Десинхронизация процессов на разных уровнях Повышение потребности миокарда в кислороде Ишемия миокарда Уменьшение сердечного выброса Магниторецепторы надпочечников Спазм прекапилляров Повышение агрегации тромбоцитов Сладж-феномен Гиперкоагуляция Замедление скорости капиллярного кровотока ?

45. Author expresses appreciation to all colleagues involved in these researches appreciation to all colleagues involved in these researches Prof. Vladimir Voeikov Lomonosov Moscow State University, Faculty of Biology Dr.Ludmila Parfenova, M.D., Ph.D. Central Clinical Hospital, JSC “Russian Railways Tamara and Eugenia Mitrofanova Institute of Terrestrial Magnetism, Ionosphere and Radio wave Propagation of Russian Academy of Sciences Institute of Terrestrial Magnetism, Ionosphere and Radio wave Propagation of Russian Academy of Sciences Research in part supported by grant RGSF № 02-06-251 Dr. Zhou Yuequn Benxi city hospital, China Dr. Leonid Kukuy and Marina Trubina City City hospital (Pokrovskaya bolnitza), Russian State Hydrometeorological UniversitySt.-Petersburg