心血管疾病的昼夜节律。

IF 35.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Ilse R Kelters, Yvonne Koop, Martin E Young, Andreas Daiber, Linda W van Laake
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引用次数: 0

摘要

昼夜节律由视交叉上核和外周时钟控制,调节心血管系统等生物过程的24小时周期。昼夜节律影响自主神经平衡,睡眠时副交感神经支配支持心脏恢复,白天交感神经激活支持循环需求。与系统和细胞昼夜节律一致,24小时模式出现在心血管疾病的病理生理学中,包括缺血性心脏病、心力衰竭和心律失常。每日变化影响心肌梗死的时间和结果,研究报告梗死大小的模式取决于发病时间。在心脑血管并发症中也观察到类似的日常模式。在心力衰竭中,昼夜节律受到抑制,但保持完整,这表明将时间纳入诊断和治疗的潜力。心脏性猝死有一个独特的模式,早晨的发病率更高。另一方面,房颤发作在夜间更为频繁。危险因素和调节因素,如生理、心理、生活方式、环境因素和合并症与昼夜节律相互作用,从而影响细胞病理机制和心血管健康和疾病的发展。时间疗法,使治疗与昼夜节律一致,已证明有潜力提高心血管治疗的疗效。这篇综述探讨了在特定心脏疾病和危险因素的背景下,昼夜节律对心血管健康的影响,并强调了昼夜节律模式提供的治疗机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Circadian rhythms in cardiovascular disease.

Circadian rhythms, controlled by the suprachiasmatic nucleus and peripheral clocks, regulate 24-h cycles in biological processes such as the cardiovascular system. Circadian rhythms influence autonomic balance, with parasympathetic dominance during sleep supporting cardiac recovery and sympathetic activation during the day supporting circulatory demand. Congruent with systemic and cellular circadian rhythmicity, 24-h patterns arise in the pathophysiology of cardiovascular diseases, including ischaemic heart disease, heart failure, and arrhythmias. Daily variations influence the timing and outcome of myocardial infarction, with studies reporting patterns in infarct size depending on the time of onset. Similar daily patterns are observed in cardio- and cerebrovascular complications. In heart failure, circadian rhythms are dampened but remain intact, suggesting the potential for incorporating timing in diagnostics and therapies. Sudden cardiac death follows a distinct pattern, with a higher incidence in the morning. Atrial fibrillation onset, on the other hand, occurs more frequently at night. Risk factors and modifiers, such as physiological, psychological, lifestyle, and environmental factors and comorbidities interact with circadian rhythms, thereby impacting cellular pathomechanisms and development of cardiovascular health and disease. Chronotherapy, which aligns treatments with circadian rhythms, has demonstrated potential for improving the efficacy of cardiovascular therapies. This review examines the influence of circadian rhythms on cardiovascular health in the context of specific cardiac diseases and risk factors, and it highlights the therapeutic opportunities informed by circadian patterns.

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来源期刊
European Heart Journal
European Heart Journal 医学-心血管系统
CiteScore
39.30
自引率
6.90%
发文量
3942
审稿时长
1 months
期刊介绍: The European Heart Journal is a renowned international journal that focuses on cardiovascular medicine. It is published weekly and is the official journal of the European Society of Cardiology. This peer-reviewed journal is committed to publishing high-quality clinical and scientific material pertaining to all aspects of cardiovascular medicine. It covers a diverse range of topics including research findings, technical evaluations, and reviews. Moreover, the journal serves as a platform for the exchange of information and discussions on various aspects of cardiovascular medicine, including educational matters. In addition to original papers on cardiovascular medicine and surgery, the European Heart Journal also presents reviews, clinical perspectives, ESC Guidelines, and editorial articles that highlight recent advancements in cardiology. Additionally, the journal actively encourages readers to share their thoughts and opinions through correspondence.
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