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The impact of early compared to late morning hours on brachial endothelial function and long-term cardiovascular events in healthy subjects with no apparent coronary heart disease.
- Source :
-
International journal of cardiology [Int J Cardiol] 2011 Sep 15; Vol. 151 (3), pp. 342-7. Date of Electronic Publication: 2010 Sep 15. - Publication Year :
- 2011
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Abstract
- Background: Adverse cardiovascular events (CVE) tend to peak during early morning post-waking hours. Our objective was to explore a possible correlation between early and late morning hours and flow-mediated dilation (FMD), and whether early morning FMD reduction contributes to a circadian pattern of cardiac and vascular vulnerability.<br />Methods: Brachial FMD was prospectively assessed in 268 consecutive healthy subjects, 169 (63%) men, mean age 53 ± 11 years, without any concomitant medications. Following an overnight fast, FMD and endothelium-independent nitroglycerin-mediated vasodilation were assessed using high-resolution ultrasound. All subjects were followed up by phone every 6 months for combined CVE, which included all-cause mortality, myocardial infarction, hospitalization for heart failure or angina pectoris, stroke, coronary artery bypass grafting and percutaneous coronary interventions.<br />Results: The cohort was divided into Group A with FMD performed immediately post-waking, between 6:00 and 10:00 am [n=151 (56%) subjects], and Group B after 10:00 am [n=117 (46%) subjects]. Although both groups were comparable regarding baseline brachial artery diameter and the prevalence of risk factors, FMD was significantly lower in Group A compared with Group B subjects (10.4 ± 3.4% vs. 13.5 ± 3.5%, p=0.007, respectively). In a mean follow-up of 45 ± 21 months, the composite CVEs were significantly more common in subjects with ≤(n=128) vs. >(n=140) the median FMD of 11.3% [18/128 (14.1%) vs. 1/140 (0.7%), p=0.007, respectively]. Furthermore, FMD independently predicted long-term adverse CVE.<br />Conclusions: FMD is blunted in early compared to late morning post-waking hours, and independently predicts long-term adverse CVE in healthy subjects with no apparent heart disease.<br /> (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Blood Flow Velocity physiology
Brachial Artery physiology
Cardiovascular Diseases physiopathology
Coronary Artery Disease diagnostic imaging
Coronary Artery Disease physiopathology
Endothelium, Vascular physiology
Female
Humans
Male
Middle Aged
Prospective Studies
Risk Factors
Time Factors
Ultrasonography
Young Adult
Brachial Artery diagnostic imaging
Cardiovascular Diseases diagnostic imaging
Circadian Rhythm physiology
Endothelium, Vascular diagnostic imaging
Health Status
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 151
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 20832878
- Full Text :
- https://doi.org/10.1016/j.ijcard.2010.08.069