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Rowland SN, James LJ, O'Donnell E, Bailey SJ. Influence of acute dietary nitrate supplementation timing on nitrate metabolism, central and peripheral blood pressure and exercise tolerance in young men. Eur J Appl Physiol 2024; 124:1381-1396. [PMID: 38040982 PMCID: PMC11055761 DOI: 10.1007/s00421-023-05369-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE Dietary nitrate (NO3-) supplementation can lower systolic blood pressure (SBP) and improve exercise performance. Salivary flow rate (SFR) and pH are key determinants of oral NO3- reduction and purported to peak in the afternoon. We tested the hypotheses that NO3--rich beetroot juice (BR) would increase plasma [nitrite] ([NO2-]), lower SBP and improve exercise performance to a greater extent in the afternoon (AFT) compared to the morning (MORN) and evening (EVE). METHOD Twelve males completed six experimental visits in a repeated-measures, crossover design. NO3--depleted beetroot juice (PL) or BR (~ 13 mmol NO3-) were ingested in the MORN, AFT and EVE. SFR and pH, salivary and plasma [NO3-] and [NO2-], brachial SBP and central SBP were measured pre and post supplementation. A severe-intensity exercise tolerance test was completed to determine cycling time to exhaustion (TTE). RESULTS There were no between-condition differences in mean SFR or salivary pH. The elevation in plasma [NO2-] after BR ingestion was not different between BR-MORN, BR-AFT and BR-EVE. Brachial SBP was unchanged following BR supplementation in all conditions. Central SBP was reduced in BR-MORN (- 3 ± 4 mmHg), BR-AFT (- 4 ± 3 mmHg), and BR-EVE (- 2 ± 3 mmHg), with no differences between timepoints. TTE was not different between BR and PL at any timepoint. CONCLUSION Acute BR supplementation was ineffective at improving TTE and brachial SBP and similarly effective at increasing plasma [NO2-] and lowering central SBP across the day, which may have implications for informing NO3- supplementation strategies.
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Affiliation(s)
- Samantha N Rowland
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Emma O'Donnell
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.
- Department of Cardiovascular Science, University of Leicester, Leicester, UK.
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Lin PS, Qi WH, Ding CY, An YJ, Yao YT. The Effects of Daytime Variation on Short-term Outcomes of Patients Undergoing Off-Pump Coronary Artery Bypass Grafting. J Cardiothorac Vasc Anesth 2024; 38:931-938. [PMID: 38246822 DOI: 10.1053/j.jvca.2023.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE To evaluate the effects of time of surgery on the short-term outcomes of patients undergoing off-pump coronary artery bypass grafting (OPCABG). DESIGN A retrospective cohort study. SETTING A single large-volume cardiovascular center. PATIENTS Patients undergoing elective OPCABG between September 2019 and July 2022. INTERVENTIONS Patients were divided into the following 2 groups according to the start time of surgery: morning (AM group, before 11 AM) and afternoon (PM group, after 11 AM). Propensity-score matching (PSM) with a 1:1 matching ratio was used to create comparable cohorts. MEASUREMENTS AND MAIN RESULTS The primary endpoint was the composite incidence of mortality and morbidities during hospitalization. Secondary endpoints included postoperative bleeding and transfusion, mechanical ventilation duration (MVD), and lengths of stay (LOS) in the intensive care unit (ICU) and hospital. From a consecutive series of 1,039 patients, PSM yielded 317 well-matched pairs. There was no difference in the composite incidence of in-hospital mortality and morbidities between the AM and PM groups (16.4% v 17.4%, p = 0.832). However, patients in the PM group were associated with less postoperative blood loss over the first 24 hours (470 v 540 mL, p = 0.002), decreased MVD (14 v 16 hours, p < 0.001), and shorter LOS in ICU (46 v 68 hours, p = 0.002) compared to patients in AM group. CONCLUSIONS The current study suggested a lack of relevance regarding the time of surgery with in-hospital mortality and morbidities in patients undergoing OPCABG.
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Affiliation(s)
- Pei-Shuang Lin
- Department of Cardiovascular Surgery, Fujian Medical University Affiliated First Quanzhou Hospital, Quanzhou, China; Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wen-Hui Qi
- Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; Department of Anesthesiology, Hengshui People's Hospital, Hengshui, China
| | - Chen-Ying Ding
- Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; Department of Anesthesiology, the First Hospital of Hohhot, Hohhot, China
| | - Yu-Jie An
- Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; Department of Anesthesiology, the Friendship Hospital of Ili Kazakh Autonomous Prefecture, Yining, China
| | - Yun-Tai Yao
- Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
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Hsiao YT, Hung JF, Zhang SQ, Yeh YN, Tsai MJ. The Impact of Emergency Department Arrival Time on Door-to-Balloon Time in Patients with ST-Segment Elevation Myocardial Infarction Receiving Primary Percutaneous Coronary Intervention. J Clin Med 2023; 12:jcm12062392. [PMID: 36983392 PMCID: PMC10059039 DOI: 10.3390/jcm12062392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Door-to-balloon (DTB) time significantly affects the prognosis of patients with ST-segment elevation myocardial infarction (STEMI). The effects of temporal differences in emergency department (ED) arrival time on DTB time and on different segments of DTB time remain inconclusive. Therefore, we performed a retrospective study in a tertiary hospital between January 2013 and December 2021 and investigated the relationship between a patient's arrival time and both their DTB time and different segments of their DTB time. Of 732 STEMI patients, 327 arrived during the daytime (08:01-16:00), 268 during the evening (16:01-24:00), and 137 at night (00:01-08:00). Significantly higher odds of delay in DTB time were observed during the nighttime (adjusted odds ratio (aOR): 2.87; 95% confidence interval (CI): 1.50-5.51, p = 0.002) than during the daytime. This delay was mainly attributed to a delay in cardiac catheterization laboratory (cath lab) activation-to-arrival time (aOR: 6.25; 95% CI: 3.75-10.40, p < 0.001), particularly during the 00:00-04:00 time range. Age, sex, triage level, and whether patients arrived during the COVID-19 pandemic also had independent effects on different segments of DTB time. Further studies are required to investigate the root causes of delay in DTB time and to develop specific strategies for improvement.
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Affiliation(s)
- Yu-Ting Hsiao
- Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan
| | - Jui-Fu Hung
- Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan
| | - Shi-Quan Zhang
- Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan
| | - Ya-Ni Yeh
- Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan
| | - Ming-Jen Tsai
- Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan
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Chang J, Deng Q, Hu P, Yang Z, Guo M, Lu F, Su Y, Sun J, Qi Y, Long Y, Liu J. Driving Time to the Nearest Percutaneous Coronary Intervention-Capable Hospital and the Risk of Case Fatality in Patients with Acute Myocardial Infarction in Beijing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3166. [PMID: 36833858 PMCID: PMC9961430 DOI: 10.3390/ijerph20043166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/24/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Timely arrival at a hospital capable of percutaneous coronary intervention (PCI) is critical in treating acute myocardial infarction (AMI). We examined the association between driving time to the nearest PCI-capable hospital and case fatality among AMI patients. A total of 142,474 AMI events during 2013-2019 from the Beijing Cardiovascular Disease Surveillance System were included in this cross-sectional study. The driving time from the residential address to the nearest PCI-capable hospital was calculated. Logistic regression was used to estimate the risk of AMI death associated with driving time. In 2019, 54.5% of patients lived within a 15-min drive to a PCI-capable hospital, with a higher proportion in urban than peri-urban areas (71.2% vs. 31.8%, p < 0.001). Compared with patients who had driving times ≤15 min, the adjusted odds ratios (95% CI, p value) for AMI fatality risk associated with driving times 16-30, 31-45, and >45 min were 1.068 (95% CI 1.033-1.104, p < 0.001), 1.189 (95% CI 1.127-1.255, p < 0.001), and 1.436 (95% CI 1.334-1.544, p < 0.001), respectively. Despite the high accessibility to PCI-capable hospitals for AMI patients in Beijing, inequality between urban and peri-urban areas exists. A longer driving time is associated with an elevated AMI fatality risk. These findings may help guide the allocation of health resources.
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Affiliation(s)
- Jie Chang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, National Clinical Research Center of Cardiovascular Diseases, Beijing 100029, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100029, China
| | - Qiuju Deng
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, National Clinical Research Center of Cardiovascular Diseases, Beijing 100029, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100029, China
| | - Piaopiao Hu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, National Clinical Research Center of Cardiovascular Diseases, Beijing 100029, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100029, China
| | - Zhao Yang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, National Clinical Research Center of Cardiovascular Diseases, Beijing 100029, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100029, China
| | - Moning Guo
- Beijing Municipal Health Big Data and Policy Research Center, Beijing Institute of Hospital Management, Beijing 100034, China
| | - Feng Lu
- Beijing Municipal Health Big Data and Policy Research Center, Beijing Institute of Hospital Management, Beijing 100034, China
| | - Yuwei Su
- School of Urban Design, Wuhan University, Wuhan 430072, China
- School of Architecture and Hang Lung Center for Real Estate, Key Laboratory of Eco Planning & Green Building, Ministry of Education, Tsinghua University, Beijing 100084, China
| | - Jiayi Sun
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, National Clinical Research Center of Cardiovascular Diseases, Beijing 100029, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100029, China
| | - Yue Qi
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, National Clinical Research Center of Cardiovascular Diseases, Beijing 100029, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100029, China
| | - Ying Long
- School of Architecture and Hang Lung Center for Real Estate, Key Laboratory of Eco Planning & Green Building, Ministry of Education, Tsinghua University, Beijing 100084, China
| | - Jing Liu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, National Clinical Research Center of Cardiovascular Diseases, Beijing 100029, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100029, China
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Ozbek M, Ildirimli K, Arik B, Aktan A, Coskun MS, Evsen A, Guzel T, Acet H, Demira M. Dependence of clinical outcomes on time of hospital admission in patients with ST-segment elevation myocardial infarction. Ann Saudi Med 2023; 43:25-34. [PMID: 36739499 PMCID: PMC9899343 DOI: 10.5144/0256-4947.2023.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There are conflicting results in studies investigating the effects of percutaneous coronary intervention (PCI) on the prognosis of patients with ST-segment elevation myocardial infarction (STEMI) during or outside of usual hospital working hours. While some researchers have reported higher mortality rates in STEMI patients admitted outside of working hours, others did not find a statistically significant difference. OBJECTIVES Investigate the short-term endpoints and long-term outcomes of STEMI patients by time of admission. DESIGN Retrospective SETTING: Tertiary percutaneous coronary intervention center. PATIENTS AND METHODS Patients were grouped by admission, which consisted of four intervals: 06:00 to <12:00, 12:00 to <18:00, 18:00 to <24:00, and 24:00 to <06:00. We analyzed demographic, clinical and mortality by admission time interval and mortality by multivariate analyses, including the time intervals. MAIN OUTCOME MEASURES Clinical data and mortality SAMPLE SIZE: 735 patients; median (IQR) age 62 (22) years; 215 (29.3%) women. RESULTS Patients admitted at night were 1.37 times more likely to experience pulmonary edema than patients whose symptoms started in the daytime (P=.012); 32.9% of the patients whose symptoms started at night presented with Killip class II-IV, while during the daytime, 21.4% presented with Killip class II-IV (P=.001). Among the patients, the most common was inferior STEMI (38.6%). However, no-reflow was significantly higher during the daytime compared to the nighttime (P=.12). The risk of the cardiac arrest on admission was 1.2 times higher in patients admitted at night (P=.034). Neither time interval of admission nor several other variables had an effect on clinical outcome or mortality. CONCLUSIONS While patients admitted at night presented with pulmonary edema and cardiogenic shock more frequently, no reflow was observed during the day after the procedure. Although patients admitted at night with STEMI presented with worse clinical conditions, similar results were observed between the groups in clinical outcomes. LIMITATIONS More "real world" results might have been obtained if the study had replicated more typical referral conditions for PCI. CONFLICT OF INTEREST None.
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Affiliation(s)
- Mehmet Ozbek
- From the Department of Cardiology, Dicle University, Diyarbakir, Turkiye
| | - Kamran Ildirimli
- From the Department of Cardiology, Dicle University, Diyarbakir, Turkiye
| | - Baran Arik
- From the Department of Cardiology, Dicle University, Diyarbakir, Turkiye
| | - Adem Aktan
- From the Department of Cardiology, Dicle University, Diyarbakir, Turkiye
| | - Mehmet Sait Coskun
- From the Department of Cardiology, Dicle University, Diyarbakir, Turkiye
| | - Ali Evsen
- From the Department of Cardiology, Dicle University, Diyarbakir, Turkiye
| | - Tuncay Guzel
- From the Department of Cardiology, Dicle University, Diyarbakir, Turkiye
| | - Halit Acet
- From the Department of Cardiology, Dicle University, Diyarbakir, Turkiye
| | - Muhammed Demira
- From the Department of Cardiology, Dicle University, Diyarbakir, Turkiye
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Serial assessment of thrombogenicity and hemodynamics in patients with type II diabetes in a clinical research unit: Evidence for circadian variations in clot formation. J Thromb Thrombolysis 2022; 54:393-400. [PMID: 36074227 DOI: 10.1007/s11239-022-02699-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Circadian fluctuations in thrombogenicity and hemostasis play a role in acute cardiovascular thrombotic events occurring in the early morning hours. There is a lack of data assessing thrombogenicity, platelet function, and hemodynamics to investigate diurnal variations in a high cardiovascular risk population. METHODS This was an exploratory, single-center study conducted in aspirin-treated patients with Type II Diabetes Mellitus (T2DM) (n = 37) with documented vascular disease and/or multiple cardiovascular risk factors. Hemodynamic monitoring and blood sample collection for thromboelastography (TEG) and platelet function testing were done serially at 7-9 AM (morning), 7-9 PM (evening), 11 PM-1 AM (night), and at 5-7 AM (awakening). RESULTS R-value measured by TEG was shorter during awakening hours than during the night and day hours (p < 0.05). There were no changes in platelet reactivity in response to arachidonic acid, adenosine diphosphate, and collagen between time points. Pulse pressure (PP) was highest during awakening hours (p < 0.05). CONCLUSION Study findings provide a mechanistic explanation for increased thrombotic events observed in the early waking hours among diabetics with multiple cardiovascular risk factors. The role of chronotherapy in reducing coagulability and PP to improve clinical outcomes should be explored.
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7
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Peng H, Sun Z, Di B, Ding X, Chen H, Li H. Contemporary impact of circadian symptom-onset patterns of acute ST-Segment elevation myocardial infarction on long-term outcomes after primary percutaneous coronary intervention. Ann Med 2021; 53:247-256. [PMID: 33349057 PMCID: PMC7877989 DOI: 10.1080/07853890.2020.1863457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Daytime variation with regard to onset time of ST-elevation myocardial infarction (STEMI) symptoms has been observed. Nevertheless, with the advanced medical therapy, it is not uncertainty if a similar circadian pattern of STEMI symptom onset occurs, as well as its possible impact on clinical outcomes. Few long-term data are available. We assess the impact of circadian symptom-onset patterns of STEMI on major adverse cardiovascular events (MACE) in more contemporary patients treated with primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS A total of 1099 consecutive STEMI patients undergoing PPCI ≤12h from symptom onset during 2013 to 2019 were classified into 4 groups by 6-h intervals according to time-of-day at symptom onset: night (0:00-5:59), morning (6:00-11:59), afternoon (12:00-17:59), and evening (18:00-23:59). Incidence of MACE including cardiovascular death and nonfatal MI during a median follow-up of 48 months was compared among the 4 groups. A morning peak of symptom onset of STEMI was detected during the period 06:00-11:59 (p < .001). Compared with other three 6-h intervals, the incidence of long-term MACE during night onset-time (18.8%, 10.1%, 10.7% and 12.4%, p = .020) was significant higher that was driven by more mortality (13.1%, 6.5%, 7.1%and 7.7%, p = .044). Night symptom-onset STEMI was independently associated with subsequent MACE (hazard ratio = 1.57, 95%CI: 1.09-2.27, p = .017) even after multivariable adjustment. CONCLUSIONS Circadian variation of STEMI symptom-onset with morning predominance still exists in contemporary practice. Night symptom-onset STEMI was independently associated with increased risk of MACE in Chinese patients treated with PPCI.
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Affiliation(s)
- Hui Peng
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
| | - Zhijun Sun
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
| | - Beibing Di
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
| | - Xiaosong Ding
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
| | - Hui Chen
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China
| | - Hongwei Li
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, P. R. China.,Department of Internal Medical, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, P. R. China
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8
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van Dongen L, de Goede P, Moeller S, Eroglu T, Folke F, Gislason G, Blom M, Elders P, Torp-Pedersen C, Tan H. Temporal variation in out-of-hospital cardiac arrest occurrence in individuals with or without diabetes. Resusc Plus 2021; 8:100167. [PMID: 34604822 PMCID: PMC8473536 DOI: 10.1016/j.resplu.2021.100167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/24/2021] [Accepted: 09/04/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Out-of-hospital cardiac arrest (OHCA) occurrence has been shown to exhibit a circadian rhythm, following the circadian rhythm of acute myocardial infarction (AMI) occurrence. Diabetes mellitus (DM) is associated with changes in circadian rhythm. We aimed to compare the temporal variation of OHCA occurrence over the day and week between OHCA patients with DM and those without. Methods In two population-based OHCA registries (Amsterdam Resuscitation Studies [ARREST] 2010-2016, n = 4163, and Danish Cardiac Arrest Registry [DANCAR], 2010-2014, n = 12,734), adults (≥18y) with presumed cardiac cause of OHCA and available medical history were included. Single and double cosinor analysis was performed to model circadian variation of OHCA occurrence. Stratified analysis of circadian variation was performed in patients with AMI as immediate cause of OHCA. Results DM patients (22.8% in ARREST, 24.2% in DANCAR) were older and more frequently had cardiovascular risk factors or previous cardiovascular disease. Both cohorts showed 24 h-rhythmicity, with significant amplitudes in single and double cosinor functions (P-range < 0.001). In both registries, a morning peak (10:00-11:00) and an evening peak (20:00-21:00) was observed in both DM and non-DM patients. No septadian variation was observed in either DM or non-DM patients (P-range 0.13-84). Conclusions In these two population-based OHCA registries, we observed a similar circadian rhythm of OHCA occurrence in DM and non-DM patients.
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Affiliation(s)
- L.H. van Dongen
- Amsterdam UMC, Academic Medical Center, University of Amsterdam, Department of Experimental and Clinical Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - P. de Goede
- Laboratory of Endocrinology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, the Netherlands
- Hypothalamic Integration Mechanisms Group, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - S. Moeller
- Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - T.E. Eroglu
- Amsterdam UMC, Academic Medical Center, University of Amsterdam, Department of Experimental and Clinical Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam, the Netherlands
- Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - F. Folke
- Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
- Emergency Medical Services Copenhagen, University of Copenhagen, Denmark
| | - G. Gislason
- Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
- The Danish Heart Foundation, Copenhagen, Denmark
| | - M.T. Blom
- Amsterdam UMC, Academic Medical Center, University of Amsterdam, Department of Experimental and Clinical Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - P.J.M. Elders
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice Medicine, Amsterdam Public Health Institute, De Boelelaan 1117, Amsterdam, Netherlands
| | - C. Torp-Pedersen
- Department of Cardiology, North Zealand Hospital, Hillerød, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Public Health, University of Copenhagen, Denmark
| | - H.L. Tan
- Amsterdam UMC, Academic Medical Center, University of Amsterdam, Department of Experimental and Clinical Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam, the Netherlands
- Netherlands Heart Institute, Utrecht, the Netherlands
- Corresponding author at: Amsterdam UMC, Academic Medical Center, Heart Center, Department of Cardiology, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
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The Vascular Circadian Clock in Chronic Kidney Disease. Cells 2021; 10:cells10071769. [PMID: 34359937 PMCID: PMC8306728 DOI: 10.3390/cells10071769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/29/2021] [Accepted: 07/09/2021] [Indexed: 12/11/2022] Open
Abstract
Chronic kidney disease is associated with extremely high cardiovascular mortality. The circadian rhythms (CR) have an impact on vascular function. The disruption of CR causes serious health problems and contributes to the development of cardiovascular diseases. Uremia may affect the master pacemaker of CR in the hypothalamus. A molecular circadian clock is also expressed in peripheral tissues, including the vasculature, where it regulates the different aspects of both vascular physiology and pathophysiology. Here, we address the impact of CKD on the intrinsic circadian clock in the vasculature. The expression of the core circadian clock genes in the aorta is disrupted in CKD. We propose a novel concept of the disruption of the circadian clock system in the vasculature of importance for the pathology of the uremic vasculopathy.
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10
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Daytime variation does not impact outcome of cardiac surgery: Results from a diverse, multi-institutional cardiac surgery network. J Thorac Cardiovasc Surg 2021; 162:56-67.e44. [DOI: 10.1016/j.jtcvs.2019.11.131] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022]
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11
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Chavva H, Brazeau DA, Denvir J, Primerano DA, Fan J, Seeley SL, Rorabaugh BR. Methamphetamine-induced changes in myocardial gene transcription are sex-dependent. BMC Genomics 2021; 22:259. [PMID: 33845768 PMCID: PMC8042975 DOI: 10.1186/s12864-021-07561-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/26/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Prior work demonstrated that female rats (but not their male littermates) exposed to methamphetamine become hypersensitive to myocardial ischemic injury. Importantly, this sex-dependent effect persists following 30 days of subsequent abstinence from the drug, suggesting that it may be mediated by long term changes in gene expression that are not rapidly reversed following discontinuation of methamphetamine use. The goal of the present study was to determine whether methamphetamine induces sex-dependent changes in myocardial gene expression and whether these changes persist following subsequent abstinence from methamphetamine. RESULTS Methamphetamine induced changes in the myocardial transcriptome were significantly greater in female hearts than male hearts both in terms of the number of genes affected and the magnitude of the changes. The largest changes in female hearts involved genes that regulate the circadian clock (Dbp, Per3, Per2, BMal1, and Npas2) which are known to impact myocardial ischemic injury. These genes were unaffected by methamphetamine in male hearts. All changes in gene expression identified at day 11 returned to baseline by day 30. CONCLUSIONS These data demonstrate that female rats are more sensitive than males to methamphetamine-induced changes in the myocardial transcriptome and that methamphetamine does not induce changes in myocardial transcription that persist long term after exposure to the drug has been discontinued.
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Affiliation(s)
- Hasitha Chavva
- Department of Pharmaceutical Science, Marshall University School of Pharmacy, 1 John Marshall Drive, Huntington, WV, 25755, USA
| | - Daniel A Brazeau
- Department of Pharmacy Practice, Administration, and Research, Marshall University School of Pharmacy, 1 John Marshall Drive, Huntington, WV, 25755, USA
- Department of Biomedical Science, Marshall University School of Medicine, 1 John Marshall Drive, Huntington, WV, 25755, USA
| | - James Denvir
- Department of Biomedical Science, Marshall University School of Medicine, 1 John Marshall Drive, Huntington, WV, 25755, USA
| | - Donald A Primerano
- Department of Biomedical Science, Marshall University School of Medicine, 1 John Marshall Drive, Huntington, WV, 25755, USA
| | - Jun Fan
- Department of Biomedical Science, Marshall University School of Medicine, 1 John Marshall Drive, Huntington, WV, 25755, USA
| | - Sarah L Seeley
- Department of Pharmaceutical and Biomedical Sciences, Ohio Northern University College of Pharmacy, 525 South Main Street, Ada, OH, 45810, USA
| | - Boyd R Rorabaugh
- Department of Pharmaceutical Science, Marshall University School of Pharmacy, 1 John Marshall Drive, Huntington, WV, 25755, USA.
- Department of Biomedical Science, Marshall University School of Medicine, 1 John Marshall Drive, Huntington, WV, 25755, USA.
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Soares AC, Fonseca DA. Cardiovascular diseases: a therapeutic perspective around the clock. Drug Discov Today 2020; 25:1086-1098. [PMID: 32320853 DOI: 10.1016/j.drudis.2020.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/05/2020] [Accepted: 04/09/2020] [Indexed: 01/21/2023]
Abstract
Biological rhythms are a ubiquitous feature of life. Most bodily functions, including physiological, biochemical, and behavioral processes, are coupled by the circadian rhythm. In the cardiovascular system, circadian fluctuations regulate several functions, namely heart rate, blood pressure, cardiac contractility, and metabolism. In fact, current lifestyles impose external timing constraints that clash with our internal circadian physiology, often increasing the risk of cardiovascular disease (CVD). Still, the mechanisms of dysregulation are not fully understood because this is a growing area of research. In this review, we explore the modulatory role of the circadian rhythms on cardiovascular function and disease as well as the role of chronotherapy in the context of CVD and how such an approach could improve existing therapies and assist in the development of new ones.
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Affiliation(s)
| | - Diogo A Fonseca
- Laboratory of Pharmacology and Pharmaceutical Care, Faculty of Pharmacy, University of Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Portugal; CIBB Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Portugal.
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Škrlec I, Milić J, Heffer M, Wagner J, Peterlin B. Circadian clock genes and circadian phenotypes in patients with myocardial infarction. Adv Med Sci 2019; 64:224-229. [PMID: 30818221 DOI: 10.1016/j.advms.2018.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 08/31/2018] [Accepted: 12/07/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Human physiological activities and diseases are under the control of the circadian rhythm. There are strong epidemiological associations between disrupted circadian rhythms, sleep duration and diseases. Sleep disorders are associated with vascular outcomes, such as myocardial infarction (MI). METHODS We conducted an association study of genotype-phenotype interaction, to determine which circadian clock gene variants might be associated with the circadian phenotypes in patients with MI. In the present study, we analyzed the allele frequencies of 10 single nucleotide polymorphisms in four circadian clock genes in two independent samples: MI patients and controls. Chronotype was assessed using the Morningness - Eveningness Questionnaire (MEQ) and daytime sleepiness using the Epworth Sleepiness Scale (ESS). RESULTS Chronotype was associated with the ARNTL genetic variant rs12363415 in MI patients. The polymorphisms rs11932595 of the CLOCK gene and rs934945 of the PER2 gene were associated with daytime sleepiness in the patient group. CONCLUSION Our data suggest that genetic variations in some circadian clock genes might be related to circadian phenotype (i.e., chronotype and daytime sleepiness) in patients with myocardial infarction.
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Affiliation(s)
- Ivana Škrlec
- Department of Biology and Chemistry, Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, Osijek, Croatia; Department of Medical Biology and Genetics, Faculty of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia.
| | - Jakov Milić
- Department of Medical Biology and Genetics, Faculty of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia
| | - Marija Heffer
- Department of Medical Biology and Genetics, Faculty of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia
| | - Jasenka Wagner
- Department of Biology and Chemistry, Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, Osijek, Croatia; Department of Medical Biology and Genetics, Faculty of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Center Ljubljana, Ljubljana, Slovenia
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Circadian onset and prognosis of myocardial infarction with non-obstructive coronary arteries (MINOCA). PLoS One 2019; 14:e0216073. [PMID: 31022242 PMCID: PMC6483255 DOI: 10.1371/journal.pone.0216073] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/12/2019] [Indexed: 01/07/2023] Open
Abstract
Background Many acute cardiovascular events such as myocardial infarction (MI) follow circadian rhythms. Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a newly noticed entity with limited data on onset pattern and its impact on prognosis. Material and methods In this observational study of Swedish MINOCA patients registered in the SWEDEHEART registry between 2003–2013 and followed until December 2013 we identified 9,092 unique patients with MINOCA out of 199,163 MI admissions in total. Incidence rate ratios (IRR) were calculated for whole hours, parts of the day, weekdays, months, seasons and major holidays. Results The mean age was 65.5 years, 62.0% were women and 16.6% presented with STEMI. The risk for MINOCA proved to be most common in the morning (IRR = 1.70, 95% CI [1.63–1.84]) with a peak at 08.00 AM (IRR = 2.25, 95% CI [1.96–2.59]) and on Mondays (IRR = 1.28, 95% CI [1.18–1.38]). No altered risk was detected during the different seasons, the Christmas and New Year holidays or the Swedish Midsummer festivities. There was no association between time of onset of MINOCA and short- or long-term prognosis. Conclusion The onset of MINOCA shows a circadian and circaseptan variation with increased risk at early mornings and Mondays, similar to previous studies on all MI, suggesting stress related triggering. However, during holidays were traditional MI increase, we did not see any increase for MINOCA. No association was detected between time of onset and prognosis, indicating that the underlying pathological mechanisms of MINOCA and the quality of care are similar at different times of onset but triggering mechanism may be more active early mornings and Mondays.
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Crnko S, Cour M, Van Laake LW, Lecour S. Vasculature on the clock: Circadian rhythm and vascular dysfunction. Vascul Pharmacol 2018; 108:1-7. [PMID: 29778521 DOI: 10.1016/j.vph.2018.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 04/23/2018] [Accepted: 05/10/2018] [Indexed: 01/08/2023]
Abstract
The master mammalian circadian clock (i.e. central clock), located in the suprachiasmatic nucleus of the hypothalamus, orchestrates the synchronization of the daily behavioural and physiological rhythms to better adapt the organism to the external environment in an anticipatory manner. This central clock is entrained by a variety of signals, the best established being light and food. However, circadian cycles are not simply the consequences of these two cues but are generated by endogenous circadian clocks. Indeed, clock machinery is found in mainly all tissues and cell types, including cells of the vascular system such as endothelial cells, fibroblasts, smooth muscle cells and stem cells. This machinery physiologically contributes to modulate the daily vascular function, and its disturbance therefore plays a major role in the pathophysiology of vascular dysfunction. Therapies targeting the circadian rhythm may therefore be of benefit against vascular disease.
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Affiliation(s)
- Sandra Crnko
- Division Heart and Lungs and Regenerative Medicine Center, University Medical Center Utrecht, The Netherlands
| | - Martin Cour
- Hatter Institute for Cardiovascular research in Africa and Lionel Opie Preclinical Imaging Core Facility, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Linda W Van Laake
- Division Heart and Lungs and Regenerative Medicine Center, University Medical Center Utrecht, The Netherlands
| | - Sandrine Lecour
- Hatter Institute for Cardiovascular research in Africa and Lionel Opie Preclinical Imaging Core Facility, Faculty of Health Sciences, University of Cape Town, South Africa.
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Farré N, Torres M, Gozal D, Farré R. Sleep and Circadian Alterations and the Gut Microbiome: Associations or Causality? CURRENT SLEEP MEDICINE REPORTS 2018. [DOI: 10.1007/s40675-018-0100-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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A Journey into the Science of Cardiovascular Chronobiology. Heart Fail Clin 2017; 13:xiii-xv. [PMID: 28865786 DOI: 10.1016/j.hfc.2017.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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