Sudden cardiac death depending on the time of day

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Study: Heart attack risk highest in the morning

The risk of a heart attack fluctuates throughout the day. The reason for this is a molecular connection between the occurrence of cardiac arrhythmias and the day-night rhythm, US researchers from the University "Case Western Reserve" in Cleveland (Ohio) report in the journal "Nature".

In their experiments on mice, the scientists led by Mukesh Jain from the University of Case Western Reserve were able to establish a clear molecular connection between the occurrence of so-called ventricular arrhythmias and the day-night rhythm. This causes an increased risk of heart attack in the morning and in the evening, the US scientists write.

Heart attack risk fluctuates during the course of the day As part of their research, the researchers tried to get to the bottom of the statistically fluctuating risk of heart attack during the day. In order to analyze the suspected connection with the "internal clock" of humans, the US scientists examined different factors, like the hormone release, the metabolism and the sleep-wake rhythm, which are connected with the 24-hour rhythm of humans become. Mukesh Jain and colleagues came across the transmission factor Klf15 (Krüppel-like factor 15), the essential influence on the 24-hour rhythm was already known from previous studies. According to the research group, Klf15 has a significant influence on the heartbeat by regulating the influx of potassium into the heart muscle cells via the so-called cardiac ion channel as a transcription factor using a protein.

Molecular relationship between cardiac rhythm and the internal clock To test the effect of the transcription factor on the electrical stability of the heartbeat, the US scientists bred genetically modified mice in which the factor Klf15 was either completely absent or was present in a significant excess. Both a deficiency and an excess of Klf15 led to the loss of the rhythmic stability of the heartbeat in the animals and an “increased susceptibility to ventricular arrhythmias,” the scientists write. The rodents were therefore subject to a significantly increased risk of dying as a result of cardiac arrhythmias. Since the level of the transcription factor fluctuates over the course of the day, this is also a possible explanation for the clearly increased risk of sudden cardiac death in the morning and slightly increased in the evening, report Mukesh Jain and colleagues. For the first time, according to the US researchers, it has been possible to prove a molecular connection between the occurrence of cardiac arrhythmias and the "internal clock" - but so far only in mice.

In further studies, it must now be checked whether "the same relationship between the risk of cardiac arrhythmias and the transcription factor Klf15 can be found in humans," explained Mukesh Jain. However, the "fluctuating probability of sudden cardiac death during the day suggests that there is a comparable molecular link between the biological clock and cardiac arrhythmia in humans," the researchers concluded in the study report. Other research also suggests that a heart attack is usually worse in the morning than in the evening. (fp)

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Video: How to prevent sudden cardiac death in the young

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