Zhu Chen, Li Shuang, Zhang Henggui
Key Laboratory of Medical Electrophysiology, Ministry of Education and Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou 646099, China.
Beijing Academy of Artificial Intelligence, Beijing 100084, China.
Int J Mol Sci. 2025 Mar 18;26(6):2728. doi: 10.3390/ijms26062728.
Emerging evidence underscores the impact of circadian rhythms on cardiovascular processes, particularly in conditions such as hypertension, myocardial infarction, and heart failure, where circadian rhythm disruptions are linked to disease progression and adverse clinical outcomes. Circadian clock proteins are intricately linked to myocardial electrophysiological remodeling and epigenetic pathways associated with arrhythmias in heart failure. In the context of heart failure, circadian clock dysregulation leads to electrophysiological remodeling in the cardiomyocytes, which can precipitate life-threatening arrhythmias such as ventricular tachycardia (VT) and ventricular fibrillation (VF). This dysregulation may be influenced by environmental factors, such as diet and exercise, as well as genetic factors. Moreover, epigenetic modifications in heart failure have been implicated in the regulation of genes involved in cardiac hypertrophy, fibrosis, and inflammation. The interplay between circadian clock proteins, myocardial electrophysiological remodeling, and epigenetic pathways in heart failure-related arrhythmias is complex and multifaceted. Further research is needed to elucidate how these processes interact and contribute to the development of arrhythmias in heart failure patients. This review aims to explore the connections between circadian rhythms, myocardial electrophysiology, and arrhythmias related to heart failure, with the goal of identifying potential therapeutic targets and interventions that may counteract the adverse effects of circadian disruptions on cardiovascular health.
新出现的证据强调了昼夜节律对心血管过程的影响，尤其是在高血压、心肌梗死和心力衰竭等疾病中，昼夜节律紊乱与疾病进展和不良临床结局相关。昼夜节律蛋白与心肌电生理重塑以及与心力衰竭心律失常相关的表观遗传途径密切相关。在心力衰竭的情况下，昼夜节律失调会导致心肌细胞发生电生理重塑，进而可能引发危及生命的心律失常，如室性心动过速（VT）和心室颤动（VF）。这种失调可能受饮食和运动等环境因素以及遗传因素的影响。此外，心力衰竭中的表观遗传修饰与参与心脏肥大、纤维化和炎症的基因调控有关。心力衰竭相关心律失常中昼夜节律蛋白、心肌电生理重塑和表观遗传途径之间的相互作用是复杂且多方面的。需要进一步研究来阐明这些过程如何相互作用并导致心力衰竭患者心律失常的发生。本综述旨在探讨昼夜节律、心肌电生理学以及与心力衰竭相关的心律失常之间的联系，以期确定可能抵消昼夜节律紊乱对心血管健康不利影响的潜在治疗靶点和干预措施。
