Comparison of Coronary Microcirculation in Female Nurses After Day-Time Versus Night-Time Shifts

Kubo, Tomoichiro; Fukuda, Shota; Hirata, Kumiko; Shimada, Kenei; Maeda, Kumiko; Komukai, Kenichi; Kono, Yasushi; Miyahana, Reiko; Nakanishi, Koki; Otsuka, Kenichiro; Jissho, Satoshi; Taguchi, Haruyuki; Yoshiyama, Minoru; Akasaka, Takashi; Yoshikawa, Junichi

doi:10.1016/j.amjcard.2011.07.028

Cited by 20 publications

(13 citation statements)

References 30 publications

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“…This technique has been validated by the intracoronary Doppler flow wire technique advanced into the coronary vessels, leading to the accurate diagnosis of physiologically obstructive coronary artery disease 20,21. Furthermore, because of the noninvasive, relatively inexpensive, and physiological nature of TTDE, TTDE-derived CFR measurement is open to innovative applications, including serial measurement of coronary microvascular function,18,22,23 because CFR is considered to be an integrated parameter that reflects the severity of coronary microvascular dysfunction. We therefore used TTDE-derived CFR to evaluate the effect of RIC on coronary microcirculation in patients with HF.…”

Section: Discussionmentioning

confidence: 99%

Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure

Kono¹,

Fukuda²,

Hanatani³

et al. 2014

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BackgroundRemote ischemic conditioning (RIC) is a treatment modality that suppresses inflammation and improves endothelial function, which are factors involved in the pathogenesis of heart failure (HF) with reduced left ventricular ejection fraction. Coronary flow reserve (CFR) is a physiological index of coronary microcirculation and is noninvasively measured by transthoracic Doppler echocardiography (TTDE). This study aimed to investigate the effects of RIC on CFR in healthy subjects and patients with HF, through the assessment by TTDE.MethodsTen patients with HF with left ventricular ejection fraction of less than 40%, and ten healthy volunteers were enrolled in this study. RIC treatment was performed twice a day for 1 week. Our custom-made RIC device was programmed to automatically conduct 4 cycles of 5 minutes inflation and 5 minutes deflation of a blood pressure cuff to create intermittent arm ischemia. CFR measurements and laboratory tests were examined before, and after 1 week of RIC treatment.ResultsOne week of RIC treatment was well tolerated in both groups. RIC treatment increased CFR from 4.0±0.9 to 4.6±1.3 (mean ± standard deviation) in healthy subjects (P=0.02), and from 1.9±0.4 to 2.3±0.7 in patients with HF (P=0.03), respectively. Systolic blood pressure in healthy subjects, and heart rate in HF patients decreased after RIC treatment (both P<0.01).ConclusionThis study demonstrated that a 1 week course of RIC treatment improved coronary microcirculation in healthy subjects and patients with HF associated with reduced left ventricular ejection fraction.

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Section: Discussionmentioning

confidence: 99%

Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure

Kono¹,

Fukuda²,

Hanatani³

et al. 2014

DDDT

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“…Flow-mediated dilation, as a measurement for brachial artery endothelial function, decreased in physicians after a 24-hour shift and in those who reported fewer sleeping hours during the shift 11,12) . In addition, coronary microcirculation has been shown to be impaired after night shift work 6) . Diastolic blood pressure was significantly elevated throughout a 24 hours period and during a night shift 13) , and heart rate variability (HRV) showed a significant increase in sympathetic tone before work and during work compared with after work 8,14) .…”

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confidence: 99%

“…Following night shift work during OCS the sleep/wake cycle is disturbed, which causes desynchronization of the natural biological rhythms 3) and may impact clinical performance 4) . Furthermore, it has been shown that experience of distress leads to elevated blood pressure, decreased heart rate variability, and endothelial dysfunction, thereby increasing the risk of cardiovascular disease 5,6) . Various biochemical and in particular endocrine parameters have been identified as responsive to stress.…”

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confidence: 99%

No stress after 24‐hour on‐call shifts?

Harbeck

Suefke

Haas

et al. 2015

Journal of Occupational Health

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No stress after 24-hour on-call shifts? : Birgit HARBECK, et al. Department of Medicine I, University of Luebeck, Germany-Objectives: Irregular sleep patterns can adversely affect physiological functions and have been associated with increased physiological and psychological stress. Nocturnal work of physicians during 24-hour on-call shifts (OCS) disrupts the sleep/wake cycle. Chronic exposure to distress has been shown to affect cardiovascular homeostasis and to impair performance in neurocognitive and simulated clinical tasks. Methods: In a prospective cohort study, biochemical and physiological stress parameters were assessed in 11 female and 9 male physicians (median age: 32 years, range 26−42 years) before a normal working day and after a 24-hour OCS in internal medicine. In addition, various tests of attentional performance (TAP) were conducted. Results: The levels of thyroid stimulating hormone (TSH) were significantly higher after a 24-hour OCS, while there were no significant changes in cortisol, epinephrine, and norepinephrine levels. Heart rate variability and skin resistance increased following an OCS, although the differences were not statistically significant. Intrinsic alertness was comparable, while phasic alertness was significantly improved following a 24-hour OCS. Focused attention tended to be better following a night shift. There was no correlation with age or medical working experience; however, men experienced more stress than women. Conclusions: Following a 24-hour OCS, (i) TSH may be an early and sensitive biochemical predictor of stress; (ii) other classical biochemical stress parameters do not depict the psychological stress perceived by physicians; (iii) there may be a mismatch between experienced and objective stress levels; (iv) neurocognitive functions are not impaired, while performance may even be improved; and (v) men might be more sensitive to distress.

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“…5 Nightshift work disturbs normal circadian rhythms, causes sleep deprivation and mental stress and impairs coronary microcirculation. 21 Shift work-associated QT prolongation was previously demonstrated by Murata et al in a 10-year follow-up study that compared 158 shift workers with 75 day workers. 22 Changes in the sympathovagal balance were found to be responsible for diurnal variations in the QT interval in a 56-subject study that assessed the QT interval at a heart rate of 60 beats/minute and a conducted a spectral analysis of heart rate variability.…”

Section: Discussionmentioning

confidence: 78%