TIME OF ONSET OF SYMPTOMS OF ACUTE MYOCARDIAL-INFARCTION
TIME OF ONSET OF SYMPTOMS OF ACUTE MYOCARDIAL-INFARCTION
复制标题
DOI：
10.1016/0002-9149(90)90577-n
复制
发表时间：
1990-07-15
影响因子：
2.8
通讯作者：
DALEN, JE
中科院分区：
文献类型：
--
作者：
GOLDBERG, RJ;BRADY, P;DALEN, JE
一些研究根据主观自我报告和客观证实，观察到早上急性心肌梗死（AMI）的发生率增加。还收集到的证据表明心源性猝死和无症状心肌缺血的发生存在昼夜节律变化。尚未发表的报告研究了 AMI 发作时间与苏醒后时间的关系。本研究调查了 137 名确诊 AMI 患者的 AMI 发作时间与觉醒的关系。有关 AMI 当天醒来时间的信息显示，在醒来后一小时内，初始 AMI 症状的出现明显增加。在所研究的患者中，大约 23% 的患者报告在醒来后 1 小时内出现 AMI 初始症状。当已知或可能导致觉醒的急性心脏症状患者被排除在外时，还观察到觉醒后不久 AMI 症状的增加。 在根据年龄、AMI 顺序和部位分类的 AMI 患者亚组中也注意到了这一点。这些结果扩展了先前对 AMI 发作的昼夜节律早晨增加的观察，并有助于将 AMI 发作昼夜节律变化的潜在触发因素的搜索范围缩小到醒来后不久可能发生的生理变化。
Several studies have observed an increased occurrence of acute myocardial infarction (AMI) in the morning based on subjective self-reports and objective confirmation. Evidence has also been collected to suggest a circadian variation in the onset of sudden cardiac death and silent myocardial ischemia. No published reports have examined the time of onset of AMI in relation to time after awakening. The present study examines the times of onset of AMI in relation to awakening in 137 patients with confirmed AMI. Information concerning time of awakening on the day of AMI revealed a marked increase in the onset of initial AMI symptoms within the first hour after awakening. Of the patients studied, approximately 23% reported onset of the initial symptoms of AMI within 1 hour after awakening. An increased onset of symptoms of AMI soon after awakening was also observed when patients in whom the acute cardiac symptoms were known to or may have caused awakening were excluded from consideration. This was also noted in subgroups of AMI patients classified according to age, order and location of AMI. These results extend previous observations of the circadian morning increase of AMI onset and assist in narrowing the search for potential triggers of the circadian variation of onset of AMI to physiologic changes that may occur soon after awakening.