急性心肌梗死按解剖部位和冠状动脉受累情况的昼夜分布。
Circadian distribution of acute myocardial infarction by anatomic location and coronary artery involvement.
作者信息
Moruzzi Paolo, Marenzi Giancarlo, Callegari Sergio, Contini Mauro
机构信息
Centro Cardiologico Monzino, I.R.C.C.S., Institute of Cardiology, University of Milan, Milan, Italy.
出版信息
Am J Med. 2004 Jan 1;116(1):24-7. doi: 10.1016/j.amjmed.2003.07.013.
PURPOSE
Acute myocardial infarction follows a circadian pattern, with a morning peak ascribed to sympathetic activation. However, about 20% of myocardial infarctions occur between midnight and 6 AM; these events may have different characteristics.
METHODS
We studied 1571 patients with acute myocardial infarction (866 anterior and 705 inferior myocardial infarctions) who were admitted to our coronary care units from January 1997 to February 2001. We noted the time of the infarction, its anatomic location, and the involved coronary arteries.
RESULTS
Inferior myocardial infarctions were more frequent during the night (midnight to 6 AM) than during other periods of the day (n = 238, 34% of all inferior infarctions, P <0.01). When coronary angiography was performed (795 patients), 92% (127/138) of inferior infarctions were due to right coronary artery occlusion, whereas only 54% (130/242) of the remaining inferior infarctions involved that artery.
CONCLUSION
Inferior myocardial infarctions occur disproportionately at night, usually due to right coronary artery occlusion. This suggests that a protective role for sleep may be limited to left coronary artery-related events.
目的
急性心肌梗死呈现昼夜节律模式，早晨高峰归因于交感神经激活。然而，约20%的心肌梗死发生在午夜至上午6点之间；这些事件可能具有不同特征。
方法
我们研究了1997年1月至2001年2月期间入住我们冠心病监护病房的1571例急性心肌梗死患者（866例前壁心肌梗死和705例下壁心肌梗死）。我们记录了梗死时间、解剖位置和受累冠状动脉。
结果
下壁心肌梗死在夜间（午夜至上午6点）比在一天中的其他时间段更频繁（n = 238，占所有下壁梗死的34%，P <0.01）。当进行冠状动脉造影时（795例患者），92%（127/138）的下壁梗死是由于右冠状动脉闭塞，而其余下壁梗死中只有54%（130/242）累及该动脉。
结论
下壁心肌梗死在夜间的发生率不成比例地高，通常是由于右冠状动脉闭塞。这表明睡眠的保护作用可能仅限于与左冠状动脉相关的事件。
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