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[Circadian rhythms in cardiovascular diseases--ischemic heart disease]
1Interní kardiologická klinika FN Brno, pracovistĕ Bohunice.
Insights
Cardiovascular events like heart attacks and strokes often occur in the morning due to circadian rhythms. Understanding plaque rupture and thrombosis mechanisms can improve prevention strategies.
Area of Science:
- Cardiovascular pathophysiology
- Epidemiology of cardiovascular events
Context:
- Advances in understanding myocardial infarction pathophysiology.
- Recognition of circadian patterns in cardiovascular event onset.
- Identification of plaque rupture and thrombosis as key mechanisms.
Purpose:
- To review key advances in cardiovascular pathophysiology.
- To highlight the circadian pattern of cardiovascular event onset.
- To discuss the role of stressors in triggering acute events.
Summary:
- Myocardial infarction onset, sudden cardiac death, and stroke exhibit a morning peak.
- Plaque rupture and thrombosis are critical in acute cardiovascular events.
- Morning stressors, including physical and mental activity, contribute to the circadian pattern.
Impact:
- Improved treatment and prevention strategies for cardiovascular diseases.
- Enhanced understanding of the timing and triggers of acute cardiac events.
- Potential for chronotherapy and personalized risk management.
Abstract:
Several key advances in understanding of pathophysiology now provide the opportunity to develop improved treatment and prevention strategies. First, the importance o mechanism of plaque rupture and thrombosis in onset of myocardial infarction. Second, there has been demonstrated, that plaques that lead to acute occlusion often have only a mild degree of stenosis. A third advance that has stimulated the field has been the recognition that time of onset of cardiac events is not random but instead shows a circadian pattern of onset. In the decade since the 1985 observation by Muller a spol. that the frequency of onset of myocardial infarction peaks at 9 a.m., numerous publications have supported this observation not only for myocardial infarction, but also for sudden cardiac death, transient myocardial ischemia, and stroke. Refinement of these epidemiological observations has led, first, to the conclusion that the morning peak in disease onset is due in part to the physical and mental stressors associated with morning awakening and activity and, second, that stressors such as heavy physical activity and anger can trigger acute cardiovascular events.