Willich S N
Department of Medicine, Free University of Berlin, Germany.
Am J Cardiol. 1990 Nov 6;66(16):15G-17G. doi: 10.1016/0002-9149(90)90387-g.
To determine if sudden cardiac death shows a circadian variation, the mortality records of the Massachusetts population and the Framingham Heart Study were analyzed. The Massachusetts mortality data analysis revealed an increased morning incidence for out-of-hospital cardiac deaths similar to that previously described for nonfatal myocardial infarction. The records of the Framingham Heart Study allowed more comprehensive analysis of the time of sudden cardiac death. In this study, a prominent circadian variation was also identified in which frequency of sudden cardiac death increased sharply between 6 A.M. and 9 P.M.; distribution was fairly even throughout the rest of the day. This circadian pattern may be explained in part by physiologic changes that increase the likelihood of ventricular fibrillation or increase the risk of thrombosis in the morning hours. The possible role of the morning increase in physical and mental activity as a trigger of sudden cardiac death requires further investigation.
为了确定心源性猝死是否存在昼夜节律变化，对马萨诸塞州人群的死亡率记录以及弗雷明汉心脏研究进行了分析。马萨诸塞州死亡率数据分析显示，院外心脏死亡的早晨发病率有所增加，这与之前描述的非致命性心肌梗死情况类似。弗雷明汉心脏研究的记录使得对心源性猝死时间进行更全面的分析成为可能。在这项研究中，也发现了一个显著的昼夜节律变化，即心源性猝死的发生率在上午6点至晚上9点之间急剧上升；在一天的其余时间里分布相当均匀。这种昼夜节律模式部分可能是由生理变化所解释的，这些生理变化增加了室颤的可能性或在早晨时段增加了血栓形成的风险。早晨身心活动增加作为心源性猝死触发因素的可能作用需要进一步研究。
