Lucente M, Rebuzzi A G, Lanza G A, Tamburi S, Cortellessa M C, Coppola E, Iannarelli M, Manzoli U
Cardiology Institute, Medical School, Catholic University of the Sacred Heart, Rome, Italy.
Am J Cardiol. 1988 Oct 1;62(10 Pt 1):670-4. doi: 10.1016/0002-9149(88)91200-3.
Circadian rhythms have been described both for acute myocardial infarction (AMI) and sudden death. In this study the diurnal distribution of ventricular tachycardia (VT) in patients with AMI was analyzed. Ninety-four AMI patients with greater than or equal to 1 VT on Holter electrocardiographic monitoring who were not taking antiarrhythmic drugs were studied. Forty-seven patients had a recent AMI (group A) and 47 an old AMI (group B). Chronobiologic analysis was made by single cosinor method. There were 157 VTs (mean 1.67 VTs/patient, range 1 to 10) in the 94 patients: 70 in group A and 87 in group B. A significant circadian rhythm of VT was found in the total population with acrophase at 2:29 P.M. The hourly distribution of VT showed a tendency to bimodality, which seemed due to a different time of peak VT occurrence in group A (significant rhythm with acrophase at 4:40 P.M.) and group B (significant rhythm with acrophase at 12:39 P.M.). Thus, the hourly VT frequency in patients with AMI has a significant circadian variation with the highest occurrence in the awake hours, similar to the rhythms described for AMI and sudden death.
急性心肌梗死（AMI）和猝死都存在昼夜节律。在本研究中，对AMI患者室性心动过速（VT）的昼夜分布进行了分析。研究了94例未服用抗心律失常药物且动态心电图监测显示有≥1次VT发作的AMI患者。47例为近期AMI患者（A组），47例为陈旧性AMI患者（B组）。采用单余弦分析法进行时间生物学分析。94例患者共发生157次VT（平均1.67次VT/患者，范围1至10次）：A组70次，B组87次。在总体人群中发现VT存在显著的昼夜节律，高峰相位在下午2:29。VT的每小时分布呈双峰趋势，这似乎是由于A组（高峰相位在下午4:40的显著节律）和B组（高峰相位在中午12:39的显著节律）VT出现高峰的时间不同所致。因此，AMI患者每小时的VT频率存在显著的昼夜变化，在清醒时间发生率最高，这与AMI和猝死所描述的节律相似。
