(Circulation. 2001;103:806.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Diurnal Variation in Endothelium-Dependent Vasodilatation Is Not Apparent in Coronary Artery Disease
From the Alfred and Baker Medical Unit, Alfred Hospital and Baker Medical Research Institute, Prahran, Victoria, Australia.
Correspondence to Jaye P.F. Chin-Dusting, PhD, Alfred and Baker Medical Unit, Baker Medical Research Institute, PO Box 6492, St Kilda Rd Central, Melbourne, Victoria 8008, Australia. E-mail j.chin{at}alfred.org.au
Background—Acute coronary syndromes present with an increased incidence from 6:00 AM to 12:00 noon. Whether endothelial function follows a diurnal rhythm and whether this rhythm is impaired in coronary artery disease (CAD) has not previously been studied.
Methods and Results—Diurnal variation in endothelium-dependent vasodilatation was examined in 10 CAD patients and 10 control subjects. Forearm blood flow responses to acetylcholine, sodium nitroprusside, and NG-monomethyl-L-arginine were determined by plethysmography at 8:00 AM, 2:00 PM, and 8:00 PM. Heart rate, blood pressure, plasma cortisol, and inflammatory markers were also determined. Heart rate and the low-frequency component of heart rate variability were greatest in the morning in control subjects, suggesting a diurnal variation in sympathetic activity. Basal forearm blood flows were significantly reduced in control subjects at 8:00 PM compared with 8:00 AM and 2:00 PM (1.2±0.2 versus 2.1±0.2 [8:00 AM] and 2.1±0.3 [2:00 PM] mL · 100 mL-1 · min-1; P<0.05) but unchanged in the CAD group. Acetylcholine (37 µg/min) responses were greater at 8:00 AM than at 8:00 PM in control subjects (12.5±3.7 versus 19.6±2.9 mL · 100 mL-1 · min-1, respectively; P<0.05), but these responses were not time dependent in the CAD group. Responses to sodium nitroprusside were similar at all time points and between those with and without CAD.
Conclusions—Thus, normal volunteers have a diurnal variation in their endothelium-dependent vasodilatation that may counteract other, potentially adverse, diurnal variations in hemodynamic and other parameters. In contrast, CAD patients who had presented with acute coronary syndromes showed a loss of this protective mechanism.
Key Words: endothelium • vasodilation • circadian rhythm • coronary disease
This article has been cited by other articles:
 |
|
 |
|
  R. Nahas Complementary and alternative medicine approaches to blood pressure reduction: An evidence-based review Can Fam Physician, November 1, 2008; 54(11): 1529 - 1533. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Duez and B. Staels The nuclear receptors Rev-erbs and RORs integrate circadian rhythms and metabolism Diabetes and Vascular Disease Research, June 1, 2008; 5(2): 82 - 88. [Abstract] [PDF]
|
|
|
|
|
|
M. J Prasai, J. T George, and E. M Scott Molecular clocks, type 2 diabetes and cardiovascular disease Diabetes and Vascular Disease Research, June 1, 2008; 5(2): 89 - 95. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Tamisier, B. E. Hunt, G. S. Gilmartin, M. Curley, A. Anand, and J. W. Weiss Hemodynamics and muscle sympathetic nerve activity after 8 h of sustained hypoxia in healthy humans Am J Physiol Heart Circ Physiol, November 1, 2007; 293(5): H3027 - H3035. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Viswambharan, J. M. Carvas, V. Antic, A. Marecic, C. Jud, C. E. Zaugg, X.-F. Ming, J.-P. Montani, U. Albrecht, and Z. Yang Mutation of the Circadian Clock Gene Per2 Alters Vascular Endothelial Function Circulation, April 24, 2007; 115(16): 2188 - 2195. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Lerman, D. R. Holmes, J. Herrmann, and B. J. Gersh Microcirculatory dysfunction in ST-elevation myocardial infarction: cause, consequence, or both? Eur. Heart J., April 1, 2007; 28(7): 788 - 797. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. M. Boak, A. M. Dart, S. J. Duffy, and J. P. F. Chin-Dusting Responses to neither exogenous nor endogenous endothelin-1 are altered in patients with hypercholesterolemia J. Lipid Res., December 1, 2005; 46(12): 2667 - 2672. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Kawada, G. Solis, N. Ivey, S. Connors, K. Dennehy, P. Modlinger, R. Hamel, J. T. Kawada, E. Imai, R. Langenbach, et al. Cyclooxygenase-1-Deficient Mice Have High Sleep-to-Wake Blood Pressure Ratios and Renal Vasoconstriction Hypertension, June 1, 2005; 45(6): 1131 - 1138. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Otto, A. Svatikova, R. B. d. M. Barretto, S. Santos, M. Hoffmann, B. Khandheria, and V. Somers Early Morning Attenuation of Endothelial Function in Healthy Humans Circulation, June 1, 2004; 109(21): 2507 - 2510. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. A.J.L. Scheer, G. A. Van Montfrans, E. J.W. van Someren, G. Mairuhu, and R. M. Buijs Daily Nighttime Melatonin Reduces Blood Pressure in Male Patients With Essential Hypertension Hypertension, February 1, 2004; 43(2): 192 - 197. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Xiang, R. Denver, M. Bailey, and H. Krum Physiologic Determinants of Endothelin Concentrations in Human Saliva Clin. Chem., December 1, 2003; 49(12): 2012 - 2019. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Lew, P. Komesaroff, M. Williams, T. Dawood, and K. Sudhir Endogenous Estrogens Influence Endothelial Function in Young Men Circ. Res., November 28, 2003; 93(11): 1127 - 1133. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Barbato, J. Bartunek, E. Wyffels, W. Wijns, G. R. Heyndrickx, and B. De Bruyne Effects of intravenous dobutamineon coronary vasomotion in humans J. Am. Coll. Cardiol., November 5, 2003; 42(9): 1596 - 1601. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Hijmering, E. S. G. Stroes, J. Olijhoek, B. A. Hutten, P. J. Blankestijn, and T. J. Rabelink Sympathetic activation markedly reduces endothelium-dependent, flow-mediated vasodilation J. Am. Coll. Cardiol., February 20, 2002; 39(4): 683 - 688. [Abstract] [Full Text] [PDF]
|
|