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Endothelial function fluctuates with diurnal variation in the frequency of ischemic episodes in patients with variant angina

Hiroaki Kawano, MD, PhD^*,*, Takeshi Motoyama, MD, PhD^*, Hirofumi Yasue, MD, PhD, Nobutaka Hirai, MD^*, Hesham M. Waly, MD, PhD, Kiyotaka Kugiyama, MD, PhD and Hisao Ogawa, MD, PhD^*

^* Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
Kumamoto Aging Research Institute, Kumamoto, Japan
Second Department of Internal Medicine, Yamanashi Medical School, Kohfu, Japan
Mansoura University Faculty of Medicine, Mansoura, Egypt

View larger version (20K): [in a new window]   Figure 1 Diurnal variation of the total myocardial ischemic episodes in all patients with variant angina (A) and that of the mean myocardial ischemic episodes in each patient (B). The frequency of ischemic episodes was highest from midnight to morning (00:00 to 08:00) and was lowest from morning to late afternoon (08:00 to 16:00). The frequency from late afternoon to midnight was higher than that from morning to late afternoon (16:00 to 00:00). *p < 0.01 vs. from midnight to morning (00:00 to 08:00). See text for details. 00:00 = midnight; 08:00 = 8 AM; 16:00 = 4 PM.

View larger version (16K): [in a new window]   Figure 2 Fluctuation of flow-mediated, endothelium-dependent vasodilation in 20 patients with variant angina (solid circles) and 20 control subjects (open circles). See text for details. *p < 0.01 by analysis of variance. 06:00 = 6 AM; 14:00 = 2 PM; 20:00 = 8 PM.

View larger version (13K): [in a new window]   Figure 3 Relationship between flow-mediated, endothelium-dependent vasodilation and the frequency of ischemic episodes. See text for details.