Document Detail

Circadian dependence of infarct size and left ventricular function after ST elevation myocardial infarction.
MedLine Citation:
PMID:  22095727     Owner:  NLM     Status:  MEDLINE    
RATIONALE: In rodents, infarct size after ischemia/reperfusion exhibits a circadian dependence on the time of coronary occlusion. It is not known if a similar circadian dependence of infarct size occurs in humans.
OBJECTIVE: To determine if humans exhibit a circadian dependence of infarct size in the setting of ST elevation myocardial infarction (STEMI).
METHODS AND RESULTS: A retrospective analysis of 1031 patients with STEMI referred for primary percutaneous coronary intervention with known ischemic times between 1 and 6 hours identified 165 patients with occluded arteries on presentation without evidence of preinfarction angina or collateral blood flow. Both ischemic duration and angiographic area at risk were not dependent on time of infarct onset. We observed that the extent of infarct size measured by creatine kinase release was significantly associated with time of day onset of infarction (P<0.0001). The greatest myocardial injury occurred at 1:00 am onset of ischemia and 5:00 am onset of reperfusion, with the peak creatine kinase measured at the peak of the curve being 82% higher than that recorded at the trough. Similarly, left ventricular ejection fraction measured within 2 days of infarction was also dependent on time of onset of STEMI with the absolute left ventricular ejection fraction at peak >7% higher than at trough (43% vs 51%; P<0.03). These findings were supported by a subgroup of patients (n = 45) who underwent cardiac MRI measurements of infarct size and area-at-risk measurements.
CONCLUSIONS: The results of this study demonstrate for the first time in humans that myocardial infarct size and left ventricular function after STEMI have a circadian dependence on the time of day onset of ischemia.
Ronald Reiter; Cory Swingen; Luke Moore; Timothy D Henry; Jay H Traverse
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-11-17
Journal Detail:
Title:  Circulation research     Volume:  110     ISSN:  1524-4571     ISO Abbreviation:  Circ. Res.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-06     Completed Date:  2012-03-25     Revised Date:  2013-09-23    
Medline Journal Info:
Nlm Unique ID:  0047103     Medline TA:  Circ Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105-10     Citation Subset:  IM    
Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, MN 55407, USA.
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MeSH Terms
Circadian Rhythm / physiology*
Cohort Studies
Creatine Kinase, MB Form / metabolism
Magnetic Resonance Imaging
Middle Aged
Myocardial Infarction / metabolism,  pathology*
Myocardial Reperfusion Injury / metabolism,  pathology
Retrospective Studies
Ventricular Function, Left / physiology*
Grant Support
Reg. No./Substance:
EC Kinase, MB Form
Comment In:
Circ Res. 2012 Jan 6;110(1):6-7   [PMID:  22223205 ]
Circ Res. 2012 Feb 3;110(3):e22; author reply e23   [PMID:  22302758 ]
Circ Res. 2012 Apr 27;110(9):e67; author reply e68   [PMID:  22539760 ]
Circ Res. 2013 May 10;112(10):e115-7   [PMID:  23661714 ]
Circ Res. 2013 Aug 2;113(4):e43-4   [PMID:  23908336 ]
Circ Res. 2013 May 10;112(10):e110-4   [PMID:  23661713 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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