Endothelial function fluctuates with diurnal variation in the frequency of ischemic episodes in patients with variant angina
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Objectives The aim of the present study was to investigate whether there is diurnal fluctuation in the endothelial function of patients with variant angina (VA).Background Coronary spasm is induced by acetylcholine and is promptly relieved by nitroglycerin. Thus, it is possible that endothelial dysfunction is involved in the pathogenesis of coronary spasm. Furthermore, the frequency of ischemic episodes is known to display diurnal variation.Methods Flow-mediated, endothelium-dependent vasodilation of the brachial arteries was measured in the early morning (6 AM), afternoon (2 PM) and evening (8 PM) in 20 patients with VA (mean age 54.5 years; 10 men and 10 women) and in 20 control subjects (mean age 54.2 years; 10 men and 10 women). All patients underwent 24-h ambulatory electrocardiographic monitoring during the study.Results Flow-mediated vasodilation in patients with VA was deteriorated by the early morning and improved by the afternoon (patients with VA at 8 PM vs. 6 AM vs. 2 PM: 7.8 +/- 2.1% (p < 0.01 vs. VA at 6 AM) vs. 5.4 +/- 2.3% vs. 8.8 +/- 1.9% (p < 0.01 vs. VA at 6 AM); control subjects: 9.5 +/- 2.8% vs. 9.0 +/- 2.2% vs. 9.9 +/- 1.9%, respectively). The frequency of spontaneous ischemic episodes was highest from midnight to morning and was lowest from morning to late afternoon (4 PM to midnight: 7 episodes; midnight to 8 AM: 25 episodes; 8 AM to 4 PM: 3 episodes).Conclusion There is diurnal fluctuation in endothelial function, which is associated with variation in the frequency of ischemic episodes.
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In humans, vascular endothelial function is relatively impaired in the morning, and therefore potentially implicated in the morning increase in adverse cardiovascular events.
“In humans, vascular endothelial function is relatively impaired in the morning (6, 123-126), and therefore potentially implicated in the morning increase in adverse CV events (127).”
From Role of the circadian system in cardiovascular disease (2018) · cites this paper as [125]
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References 30 · Cited by 73
Research works printed but not linked: 3
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- Corretti MC, Plotnick GD, Vogel RA. Technical aspects of evaluating brachial artery endothelium-dependent vasodilatation using high fre- quency ultrasound. Am J Physiol 1995;268:H1397-404.
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- Authors
- Kawano, H., Motoyama, T., Yasue, H., Hirai, N., Waly, H. M., Kugiyama, K., & Ogawa, H.
- Affiliations
- Kumamoto University (JP)
- Kumamoto University Hospital (JP)
- Mansoura University (EG)
- University of Yamanashi (JP)
- Corresponding author
- Kawano, Hiroaki
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2002-07
- Volume
- 40
- Issue
- 2
- Pages
- 266-270
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W371697969
- Cited by
- 73
- References
- 30
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 2 · 2016: 4 · 2015: 5 · 2014: 8 · 2013: 2 · 2012: 7
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Japanese Circulation Journal-english Edition
- Funders
- Japan Cardiovascular Research Foundation
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- vasospastic angina, endothelial dysfunction, diurnal variation, flow-mediated dilation, coronary vasospasm, ischemic episodes, brachial artery, acetylcholine, nitroglycerin, Holter monitoring
- MeSH terms
- Aged, Angina Pectoris, Variant, Circadian Rhythm, Coronary Circulation, Endothelium, Vascular, Female, Humans, Male, Middle Aged
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