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While circadian variation of occurrence of cardiovascular emergencies has been de-scribed, it has not been assessed whether fluctuations of gravitational interaction between the Earth and the Moon may in-duce other types of its variation in time have the similar impact. Therefore, we decided to evaluate whether there is an as-sociation between the occurrence of pre-hospital cardiogenic pulmonary edema (CPE) episodes treated by Emergency Medical Services (EMS) and fluctuations in the intensity of gravitational interaction between the Earth and the Moon. Methods. We extracted all dispatches to CPE episodes from the EMS database of the Central Bohemian Region, Czech Re-public, between 2.11.2008 and 1.7.2014. For each episode, the intensity of gravita-tional interaction between the Moon and the Earth was calculated. The study period was divided into 11 sections of equal dura-tion according to the different intensity of gravitational interaction, and occurrence of CPE was compared among the groups. Results. We observed up to 4,744 episodes of CPE during the study period. Occur-rence of CPE episodes was highest in the periods with the weakest intensity of gravitational interaction (≤1.80e1026 N), while in the periods of the most intense gravitational interaction (≥2.26e1026 N), the lowest proportion of CPE cases was observed (23.44 vs. 3.79 %, p <0.001). Conclusions. We identified a significant association between the intensity of gravi-tational interaction between the Earth and the Moon and occurrence of CPE, treated by our EMS. The weakest intensity was as-sociated with its increased occurrence and vice versa. Further research is required for potential use of this phenomenon in a chronotherapeutic approach to secondary prevention of CPE.

Impact of gravitational interaction between the Moon and the Earth on the occurrence of episodes of cardiogenic pulmonary edema in the field