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Titolo:
NONUNIFORM NIGHTTIME DISTRIBUTION OF ACUTE CARDIAC EVENTS - A POSSIBLE EFFECT OF SLEEP STATES
Autore:
LAVERY CE; MITTLEMAN MA; COHEN MC; MULLER JE; VERRIER RL;
Indirizzi:
BETH ISRAEL DEACONESS MED CTR,INST PREVENT CARDIOVASC DIS,DEPT MED,DIV CARDIOVASC,1 AUTUMN ST BOSTON MA 02215 BETH ISRAEL DEACONESS MED CTR,INST PREVENT CARDIOVASC DIS,DEPT MED,DIV CARDIOVASC BOSTON MA 02215 HARVARD UNIV,SCH MED,DEPT EPIDEMIOL BOSTON MA 00000 UNIV KENTUCKY,DEPT INTERNAL MED,DIV CARDIOVASC MED LEXINGTON KY 00000
Titolo Testata:
Circulation
fascicolo: 10, volume: 96, anno: 1997,
pagine: 3321 - 3327
SICI:
0009-7322(1997)96:10<3321:NNDOAC>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS; CORONARY HEMODYNAMIC FUNCTION; CIRCADIAN VARIATION; VENTRICULAR TACHYARRHYTHMIAS; PHYSICAL EXERTION; SUDDEN-DEATH; CHEST PAIN; MORNING INCREASE; BLOOD-PRESSURE;
Keywords:
SLEEP; NERVOUS SYSTEM, AUTONOMIC; METAANALYSIS; CIRCADIAN RHYTHM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
56
Recensione:
Indirizzi per estratti:
Citazione:
C.E. Lavery et al., "NONUNIFORM NIGHTTIME DISTRIBUTION OF ACUTE CARDIAC EVENTS - A POSSIBLE EFFECT OF SLEEP STATES", Circulation, 96(10), 1997, pp. 3321-3327

Abstract

Background Although 250000 myocardial infarctions and 38000 sudden cardiac deaths occur at night annually, this public health problem is underappreciated and poorly understood. We examined whether the incidence of myocardial infarction, sudden cardiac death, and automatic implantable cardioverter-defibrillator (AICD) discharge was nonuniform, a result that may implicate physiological triggers such as sleep-state dependent changes in autonomic nervous system activity. Methods and Results We conducted a review of the circadian pattern of the onset of myocardial infarction (n = 19), sudden cardiac death (n = 12), and AICD discharge (n = 7). The nighttime period was chosen a priori as midnight to 5:59 AM. These reports documented 11633 nocturnal myocardial infarctions (20% of the total myocardial infarctions), 1981 nocturnal suddencardiac deaths (14.6% of the total sudden cardiac deaths), and 1200 nocturnal AICD discharges (15.0% of the total discharges). The distributions of myocardial infarction, sudden cardiac death, and AICD discharge were each significantly nonuniform (P < .001). The peak incidence of myocardial infarction and AICD discharge occurred between midnight and 0:59 AM, whereas the peak incidence of sudden cardiac death was between 1:00 and 1:59 AM. The trough in incidence occurred between 4:00 and 4:59 AM for sudden cardiac death and between 3:00 and 3:59 AM for myocardial infarction and AICD discharge. Conclusions Nocturnal myocardial infarction, sudden cardiac death, and AICD discharge exhibit nonuniform distributions. This finding is consistent with the hypothesis that sleep-state dependent fluctuations in autonomic nervous system activity may trigger the onset of major cardiovascular events and providesfurther impetus for more directly testing this hypothesis at population, individual, and mechanistic levels. A better understanding of nocturnal triggers may make it possible to reduce the incidence of myocardial infarction, ventricular tachyarrhythmias, and sudden cardiac deathduring the nocturnal period.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 05:32:54