Advertisement

Click here for more guidelines.

 
 




CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 1994; 23:1405-1409
© 1994 by the American College of Cardiology Foundation
This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Maron, B.
Right arrow Articles by Roberts, W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Maron, B.
Right arrow Articles by Roberts, W.

Circadian variability in the occurrence of sudden cardiac death in patients with hypertrophic cardiomyopathy

BJ Maron, J Kogan, MA Proschan, GM Hecht, and WC Roberts

Cardiovascular Research Division, Minneapolis Heart Institute Foundation, Minnesota 55407.

OBJECTIVES. The present study examined whether sudden death in patients with hypertrophic cardiomyopathy occurred with a particular pattern of frequency throughout the day. BACKGROUND. Previous investigators have shown a circadian distribution in the occurrence of sudden death and other cardiovascular events in patients with atherosclerotic coronary artery disease. Sudden death is also an important feature of the natural history of patients with hypertrophic cardiomyopathy. METHODS. The study group comprised 94 patients with a time of death (or cardiac arrest) that could be ascertained accurately to the nearest hour. This hourly distribution was analyzed by harmonic regression. RESULTS. Sudden death did not occur uniformly or randomly throughout the day. Rather, it was distributed in a bimodal pattern that conformed to a two-harmonic regression model. A disproportionate number of sudden deaths (43 [46%] of 94) occurred in the first peak in midmorning between 7 AM and 1 PM. The second peak of sudden death was less distinct but was in the early evening, between 8 PM and 10 PM. This periodicity in occurrence of sudden cardiac death was not evident for the days of the week or months of the year and, furthermore, did not appear to be influenced by other clinical variables, such as age, gender, severity of symptoms, subaortic gradient or left ventricular wall thickness. Sudden death occurred most commonly during periods of severe exertion (37 [39%] of 94). CONCLUSIONS. Sudden death in hypertrophic cardiomyopathy demonstrates a bimodal pattern of circadian variability over the 24-h day, with a prominent midmorning peak similar to that described in patients with coronary artery disease, and a less striking early-evening peak of occurrence. These findings suggest that temporally related physiologic changes, possibly in the electrical vulnerability of the myocardial substrate, may play a role in the sudden death of patients with hypertrophic cardiomyopathy.


This article has been cited by other articles:


Home page
EuropaceHome page
C. O'Mahony, P. D. Lambiase, S. M. Rahman, M. Cardona, M. Calcagnino, G. Quarta, K. Tsovolas, S. Al-Shaikh, W. McKenna, and P. Elliott
The relation of ventricular arrhythmia electrophysiological characteristics to cardiac phenotype and circadian patterns in hypertrophic cardiomyopathy
Europace, November 16, 2011; (2011) eur362v1.
[Abstract] [Full Text] [PDF]


Home page
PhysiologyHome page
O. Froy
Circadian Rhythms, Aging, and Life Span in Mammals
Physiology, August 1, 2011; 26(4): 225 - 235.
[Abstract] [Full Text] [PDF]


Home page
Circ. Res.Home page
H. E. Collins and G. C. Rodrigo
Inotropic Response of Cardiac Ventricular Myocytes to {beta}-Adrenergic Stimulation With Isoproterenol Exhibits Diurnal Variation: Involvement of Nitric Oxide
Circ. Res., April 16, 2010; 106(7): 1244 - 1252.
[Abstract] [Full Text] [PDF]


Home page
Endocr RevHome page
O. Froy
Metabolism and Circadian Rhythms--Implications for Obesity
Endocr. Rev., February 1, 2010; 31(1): 1 - 24.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Heart Circ. Physiol.Home page
A. U. Viola, L. M. James, S. N. Archer, and D.-J. Dijk
PER3 polymorphism and cardiac autonomic control: effects of sleep debt and circadian phase
Am J Physiol Heart Circ Physiol, November 1, 2008; 295(5): H2156 - H2163.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
In Collaboration With the American College of Spor, P. D. Thompson, B. A. Franklin, G. J. Balady, S. N. Blair, D. Corrado, N.A. M. Estes III, J. E. Fulton, N. F. Gordon, W. L. Haskell, et al.
Exercise and Acute Cardiovascular Events: Placing the Risks Into Perspective: A Scientific Statement From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology
Circulation, May 1, 2007; 115(17): 2358 - 2368.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. S. Adabag, S. A. Casey, M. A. Kuskowski, A. G. Zenovich, and B. J. Maron
Spectrum and prognostic significance of arrhythmias on ambulatory Holter electrocardiogram in hypertrophic cardiomyopathy
J. Am. Coll. Cardiol., March 1, 2005; 45(5): 697 - 704.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
B. J. Maron, W. J. McKenna, G. K. Danielson, L. J. Kappenberger, H. J. Kuhn, C. E. Seidman, P. M. Shah, W. H. Spencer III, P. Spirito, F. J. Ten Cate, et al.
American College of Cardiology/European Society of Cardiology Clinical Expert Consensus Document on Hypertrophic Cardiomyopathy: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines
J. Am. Coll. Cardiol., November 5, 2003; 42(9): 1687 - 1713.
[Full Text] [PDF]


Home page
Eur Heart JHome page
Writing Committee Members, B. J. Maron, W. J. McKenna, G. K. Danielson, L. J. Kappenberger, H. J. Kuhn, C. E. Seidman, P. M. Shah, W. H. Spencer III, P. Spirito, et al.
American College of Cardiology/European Society of Cardiology Clinical Expert Consensus Document on Hypertrophic Cardiomyopathy: A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines
Eur. Heart J., November 1, 2003; 24(21): 1965 - 1991.
[Full Text] [PDF]


Home page
CirculationHome page
K. Kario, T. G. Pickering, Y. Umeda, S. Hoshide, Y. Hoshide, M. Morinari, M. Murata, T. Kuroda, J. E. Schwartz, and K. Shimada
Morning Surge in Blood Pressure as a Predictor of Silent and Clinical Cerebrovascular Disease in Elderly Hypertensives: A Prospective Study
Circulation, March 18, 2003; 107(10): 1401 - 1406.
[Abstract] [Full Text] [PDF]


Home page
J Biol RhythmsHome page
A. U. Viola, C. Simon, J. Ehrhart, B. Geny, F. Piquard, A. Muzet, and G. Brandenberger
Sleep Processes Exert a Predominant Influence on the 24-h Profile of Heart Rate Variability
J Biol Rhythms, December 1, 2002; 17(6): 539 - 547.
[Abstract] [PDF]


Home page
Cardiovasc ResHome page
R.C. Saumarez and A.A. Grace
Paced ventricular electrogram fractionation and sudden death in hypertrophic cardiomyopathy and other non-coronary heart diseases
Cardiovasc Res, July 1, 2000; 47(1): 11 - 22.
[Full Text] [PDF]


Home page
Am. J. Physiol. Heart Circ. Physiol.Home page
P. D. Penev, D. E. Kolker, P. C. Zee, and F. W. Turek
Chronic circadian desynchronization decreases the survival of animals with cardiomyopathic heart disease
Am J Physiol Heart Circ Physiol, December 1, 1998; 275(6): H2334 - H2337.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
M. Peckova, C. E. Fahrenbruch, L. A. Cobb, and A. P. Hallstrom
Circadian Variations in the Occurrence of Cardiac Arrests : Initial and Repeat Episodes
Circulation, July 7, 1998; 98(1): 31 - 39.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
C. E. Lavery, M. A. Mittleman, M. C. Cohen, J. E. Muller, and R. L. Verrier
Nonuniform Nighttime Distribution of Acute Cardiac Events : A Possible Effect of Sleep States
Circulation, November 18, 1997; 96(10): 3321 - 3327.
[Abstract] [Full Text]


Home page
JAMAHome page
B. J. Maron, J. Shirani, L. C. Poliac, R. Mathenge, W. C. Roberts, and F. O. Mueller
Sudden Death in Young Competitive Athletes: Clinical, Demographic, and Pathological Profiles
JAMA, July 17, 1996; 276(3): 199 - 204.
[Abstract] [PDF]


Home page
CirculationHome page
H. R. Middlekauff and E. M. Sontz
Morning Sympathetic Nerve Activity Is Not Increased in Humans : Implications for Mechanisms Underlying the Circadian Pattern of Cardiac Risk
Circulation, May 15, 1995; 91(10): 2549 - 2555.
[Abstract] [Full Text]



 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement