Cardiac Clocks and Preclinical Translation

Mistry, Priya; Duong, Austin; Kirshenbaum, Lorrie A.; Martino, Tami A.

doi:10.1016/j.hfc.2017.05.002

Cited by 40 publications

(22 citation statements)

References 150 publications

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“…In addition to myocardial infarction, circadian rhythm variations also influence the onset of other vascular events, including stroke and venous thromboembolism (VTE) . Numerous studies have confirmed that the onset of stroke is predominant in the morning, between 6 am and noon, when circulating cortisol levels are also at its peak . The incidence of stroke steadily declines during the remainder of the day and is least likely to occur in the late evening, coinciding with the decline in circulating cortisol levels .…”

Section: Discussionmentioning

confidence: 99%

Frequency of post‐tonsillectomy hemorrhage relative to time of day

et al. 2019

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Objectives Postoperative hemorrhage is a serious complication of tonsillectomy, with secondary bleeding rates affecting up to 0.8% to 3% of patients. Although these bleeds are anecdotally perceived as occurring more frequently at night, the occurrence of hemorrhage relative to the time of day has not been investigated. We measured the frequency of post‐tonsillectomy hemorrhage onset relative to the time of day. Methods We reviewed electronic medical records of all patients who experienced postprocedural hemorrhage (International Classification of Disease, Ninth Edition [ICD‐9] 998.11, ICD‐10 J95.830 at two hospitals within a tertiary academic health system in a 10‐year period). Patient demographics, time of bleed onset, emergency room [ED] arrival time, and management (operating room vs. observation) were abstracted. Patients without a recorded bleeding time were excluded. Time of bleed onset was categorized as morning (6:01 am–12 pm), afternoon (12:01 pm–6 pm), evening (6:01 pm–12 am), or overnight (12:01 am–6 am). Chi‐square goodness of fit test was used to assess the distribution of hemorrhage timing (P ≤ 0.05). Results A total of 7,396 patients underwent tonsillectomy May 2008 through May 2018, among whom 121 (2%) post‐tonsillectomy hemorrhage patients were identified. Among the 104 patients with ED arrival times, 29 (28%) arrived in the morning; 15 (14%) arrived in the afternoon; 40 (38%) arrived in the evening; and 20 (19%) arrived overnight (P = 0.003). Sixty patients (mean age 17.1 years, standard deviation 16.6) had a recorded timing of bleed onset. Bleed onset occurred most commonly overnight (24, 40%), followed by evening (21, 35%), afternoon (11, 18%), and morning (4, 7%) (P = 0.0007). Conclusion In this cohort, post‐tonsillectomy hemorrhage occurred most frequently between midnight and 6 am. Our findings confirm anecdotal experience and provide data in setting caregiver expectations. Level of Evidence 4 Laryngoscope, 130:1823–1827, 2020

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Section: Discussionmentioning

confidence: 99%

Frequency of post‐tonsillectomy hemorrhage relative to time of day

et al. 2019

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“…Non-dipping was more prevalent in African-Americans. For an excellent in-depth review in the area of the cardiac clock and its implications for human health, see Mistry et al [39].…”

Section: Mechanisms Of Circadian Bp Regulation In Humansmentioning

confidence: 99%

Circadian clock-mediated regulation of blood pressure

Douma

Gumz

2018

Free Radical Biology and Medicine

198

164

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Most bodily functions vary over the course of a 24h day. Circadian rhythms in body temperature, sleep-wake cycles, metabolism, and blood pressure (BP) are just a few examples. These circadian rhythms are controlled by the central clock in the suprachiasmatic nucleus (SCN) of the hypothalamus and peripheral clocks located throughout the body. Light and food cues entrain these clocks to the time of day and this synchronicity contributes to the regulation of a variety of physiological processes with effects on overall health. The kidney, brain, nervous system, vasculature, and heart have been identified through the use of mouse models and clinical trials as peripheral clock regulators of BP. The dysregulation of this circadian pattern of BP, with or without hypertension, is associated with increased risk for cardiovascular disease. The mechanism of this dysregulation is unknown and is a growing area of research. In this review, we highlight research of human and mouse circadian models that has provided insight into the roles of these molecular clocks and their effects on physiological functions. Additional tissue-specific studies of the molecular clock mechanism are needed, as well as clinical studies including more diverse populations (different races, female patients, etc.), which will be critical to fully understand the mechanism of circadian regulation of BP. Understanding how these molecular clocks regulate the circadian rhythm of BP is critical in the treatment of circadian BP dysregulation and hypertension.

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“…Coronary artery disease frequently leads to myocardial infarction (MI; heart attack), and subsequently the development of heart failure (HF), for which there is no cure. Previously, clinical studies revealed that the circadian system underlies healthy cardiovascular physiology, for example, driving 24-h day and night rhythms in heart rate [5], blood pressure [6], and timing of onset of adverse cardiovascular events [7][8][9][10][11]. Most recently, experimental studies by our group and others show that the circadian system also plays a critical role in remodeling in cardiovascular disease.…”

Section: Introductionmentioning

confidence: 95%

Circadian influence on the microbiome improves heart failure outcomes

Mistry

Reitz

Khatua

et al. 2020

Journal of Molecular and Cellular Cardiology

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Myocardial infarction (MI) leading to heart failure (HF) is a major cause of death worldwide. Previous studies revealed that the circadian system markedly impacts cardiac repair post-MI, and that light is an important environmental factor modulating the circadian influence over healing. Recent studies suggest that gut physiology also affects the circadian system, but how it contributes to cardiac repair post-MI and in HF is not well understood. To address this question, we first used a murine coronary artery ligation MI model to reveal that an intact gut microbiome is important for cardiac repair. Specifically, gut microbiome disruption impairs normal inflammatory responses in infarcted myocardium, elevates adverse cardiac gene biomarkers, and leads to worse HF outcomes. Conversely, reconstituting the microbiome post-MI in mice with prior gut microbiome disruption improves healing, consistent with the notion that normal gut physiology contributes to cardiac repair. To investigate a role for the circadian system, we initially utilized circadian mutant Clock ∆19/∆19 mice, revealing that a functional circadian mechanism is necessary for gut microbiome benefits on post-MI cardiac repair and HF. Finally, we demonstrate that circadian-mediated gut responses that benefit cardiac repair can be conferred by time-restricted feeding, as wake time feeding of MI mice improves HF outcomes, but these benefits are not observed in MI mice fed during their sleep time. In summary, gut physiology is important for cardiac repair, and the circadian system influences the beneficial gut responses to improve post-MI and HF outcomes.

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Cardiac Clocks and Preclinical Translation

Cited by 40 publications

References 150 publications

Frequency of post‐tonsillectomy hemorrhage relative to time of day

Frequency of post‐tonsillectomy hemorrhage relative to time of day

Circadian clock-mediated regulation of blood pressure

Circadian influence on the microbiome improves heart failure outcomes

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