Heart attack severity linked to time of day
Monday 21st November 2011
The severity of a heart attack depends on the time of day at which it occurs, new research has shown in a development that could affect the treatment given by Cardiac Physiotherapists.
A study published online in journal Circulation Research found that the size of a heart attack and the subsequent left-ventricular function are significantly different based on when the onset of ischemia occurs.
The greatest amount of injury to the heart happens when individuals have a heart attack between the hours of 01.00 and 05.00 GMT.
Jay H Traverse, the senior author of the study, explained: 'We were trying to ascertain whether the time of day of when a heart attack occurs influences the amount of damage that the heart sustains, or was this just a phenomenon exhibited in rodents.'
The retrospective analysis looked at a database of patients with an acute heart attack, or ST-elevation myocardial infarction (STEMI), referred for primary percutaneous coronary intervention (PCI), with well known ischemic times between one and six hours.
Of 1,031 of these patients, 165 were identified as having experienced their first heart attack, who had occluded arteries on presentation without evidence of pre-infarction angina or collateral blood flow.
Research discovered that the extent of infarct size was significantly linked to the time of day of the onset of the infarction.
The worst myocardial injury occurred at a 01.00 GMT onset of ischemia and a 05.00 GMT onset of reperfusion, with peak injury being 82 per cent higher compared to that recorded at the lowest time of injury.
"It is important to understand that the heart's ability to protect itself against more severe damage varies over a 24-hour cycle. Identifying those protective changes may be particularly relevant for pharmaceutical manufacturers that are seeking to develop cardioprotective drugs," explained Traverse.
In other news, University of Leeds research has indicated that doctors should treat the leg muscles of chronic heart failure patients as well as their cardiac problems.
Leg muscle dysfunction was found to be related to the severity of heart failure symptoms, suggesting that a failing heart could impact on the leg muscles themselves.
Written by James Puckle
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