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Delisle BP, Prabhat A, Burgess DE, Ono M, Esser KA, Schroder EA. Circadian Regulation of Cardiac Arrhythmias and Electrophysiology. Circ Res 2024; 134:659-674. [PMID: 38484028 DOI: 10.1161/circresaha.123.323513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Circadian rhythms in physiology and behavior are ≈24-hour biological cycles regulated by internal biological clocks (ie, circadian clocks) that optimize organismal homeostasis in response to predictable environmental changes. These clocks are present in virtually all cells in the body, including cardiomyocytes. Many decades ago, clinicians and researchers became interested in studying daily patterns of triggers for sudden cardiac death, the incidence of sudden cardiac death, and cardiac arrhythmias. This review highlights historical and contemporary studies examining the role of day/night rhythms in the timing of cardiovascular events, delves into changes in the timing of these events over the last few decades, and discusses cardiovascular disease-specific differences in the timing of cardiovascular events. The current understanding of the environmental, behavioral, and circadian mechanisms that regulate cardiac electrophysiology is examined with a focus on the circadian regulation of cardiac ion channels and ion channel regulatory genes. Understanding the contribution of environmental, behavioral, and circadian rhythms on arrhythmia susceptibility and the incidence of sudden cardiac death will be essential in developing future chronotherapies.
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Affiliation(s)
- Brian P Delisle
- Department of Physiology, University of Kentucky, Lexington (B.P.D., A.P., D.E.B.)
| | - Abhilash Prabhat
- Department of Physiology, University of Kentucky, Lexington (B.P.D., A.P., D.E.B.)
| | - Don E Burgess
- Department of Physiology, University of Kentucky, Lexington (B.P.D., A.P., D.E.B.)
| | - Makoto Ono
- Division of Cardiology and Rehabilitation, Tamaki Hospital, Japan (M.O.)
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Martino TA, Delisle BP. Cardiovascular research and the arrival of circadian medicine. Chronobiol Int 2023; 40:1-3. [PMID: 37096348 PMCID: PMC11027555 DOI: 10.1080/07420528.2022.2151862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Affiliation(s)
- Tami A Martino
- Centre for Cardiovascular Investigations, Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Brian P Delisle
- Department of Physiology, University of Kentucky, Lexington, Kentucky, USA,
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Schroder EA, Ono M, Johnson SR, Rozmus ER, Burgess DE, Esser KA, Delisle BP. The role of the cardiomyocyte circadian clocks in ion channel regulation and cardiac electrophysiology. J Physiol 2022; 600:2037-2048. [PMID: 35301719 PMCID: PMC9980729 DOI: 10.1113/jp282402] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/04/2022] [Indexed: 11/08/2022] Open
Abstract
Daily variations in cardiac electrophysiology and the incidence for different types of arrhythmias reflect ≈24 h changes in the environment, behaviour and internal circadian rhythms. This article focuses on studies that use animal models to separate the impact that circadian rhythms, as well as changes in the environment and behaviour, have on 24 h rhythms in heart rate and ventricular repolarization. Circadian rhythms are initiated at the cellular level by circadian clocks, transcription-translation feedback loops that cycle with a periodicity of 24 h. Several studies now show that the circadian clock in cardiomyocytes regulates the expression of cardiac ion channels by multiple mechanisms; underlies time-of-day changes in sinoatrial node excitability/intrinsic heart rate; and limits the duration of the ventricular action potential waveform. However, the 24 h rhythms in heart rate and ventricular repolarization are primarily driven by autonomic signalling. A functional role for the cardiomyocyte circadian clock appears to buffer the heart against perturbations. For example, the cardiomyocyte circadian clock limits QT-interval prolongation (especially at slower heart rates), and it may facilitate the realignment of the 24 h rhythm in heart rate to abrupt changes in the light cycle. Additional studies show that modifying rhythmic behaviours (including feeding behaviour) can dramatically impact the 24 h rhythms in heart rate and ventricular repolarization. If these mechanisms are conserved, these studies suggest that targeting endogenous circadian mechanisms in the heart, as well as modifying the timing of certain rhythmic behaviours, could emerge as therapeutic strategies to support heart function against perturbations and regulate 24 h rhythms in cardiac electrophysiology.
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Affiliation(s)
- Elizabeth A. Schroder
- Department of Physiology, University of Kentucky, 800 Rose Street, MN508, Lexington, KY 40536-0298,Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, 740 S. Limestone Street, L543, Lexington, KY 40536-0284
| | - Makoto Ono
- Department of Physiology, University of Kentucky, 800 Rose Street, MN508, Lexington, KY 40536-0298
| | - Sidney R. Johnson
- Department of Physiology, University of Kentucky, 800 Rose Street, MN508, Lexington, KY 40536-0298
| | - Ezekiel R. Rozmus
- Department of Physiology, University of Kentucky, 800 Rose Street, MN508, Lexington, KY 40536-0298
| | - Don E. Burgess
- Department of Physiology, University of Kentucky, 800 Rose Street, MN508, Lexington, KY 40536-0298
| | - Karyn A. Esser
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL, USA
| | - Brian P. Delisle
- Department of Physiology, University of Kentucky, 800 Rose Street, MN508, Lexington, KY 40536-0298
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