Decreased circadian blood pressure variation up to three years after heart transplantation

Idema, R. N.; Meiracker, Anton H. van den; Balk, A. H. M. M.; Bos, Egbert; Schalekamp, M. A. D. H.; in'tVeld, Arie J. Man

doi:10.1016/0002-9149(94)90158-9

Cited by 11 publications

(3 citation statements)

References 12 publications

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“…They postulated that the difference could be related to partial cardiac re-innervation. In contrast, Idema et al 36 in a further cross-sectional study reported that decreased circadian BP variation persists for up to 36 months after transplant. In a crosssectional study in 27 patients in whom 24-h BP recordings were obtained from 1 to 11 years after transplant, there was no significant association between time after transplant and day-night decrease in BP.…”

Section: Abnormal Nocturnal Bp Fall In Transplant Recipientsmentioning

confidence: 81%

Hypertension in thoracic transplant recipients

Jenkins

Singer

1998

J Hum Hypertens

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There are many mechanisms underlying the hypertension which occurs after thoracic transplantation. Previous disease, effects of cyclosporin, tacrolimus and steroid immunosuppression and cardiac denervation are major contributory factors. Abnormal sodium and water balance is an important common mediating factor. A new approach is clearly needed for classifying the severity of hypertension in these patients taking into account day-night variation and total blood pressure

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Section: Abnormal Nocturnal Bp Fall In Transplant Recipientsmentioning

confidence: 81%

Hypertension in thoracic transplant recipients

Jenkins

Singer

1998

J Hum Hypertens

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“…However, it has been reported that transgenic knockout of the M2 receptor or β1, β2 and β3 adrenoceptors has no effect on the circadian rhythm in heart rate in vivo 51 . In addition, cardiac transplant patients with autonomic denervation have a preserved nocturnal bradycardia 7-36 months after transplantation 52,53 . This work does not support a role for the autonomic nervous system in the circadian rhythm in heart rate in vivo .…”

Section: Discussionmentioning

confidence: 99%

Circadian control of intrinsic heart rate via a sinus node clock and the pacemaker channel

Wang

Olieslagers

Johnsen

et al. 2019

Preprint

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29In the human, there is a circadian rhythm in the resting heart rate and it is higher during the day in 30 preparation for physical activity. Conversely, slow heart rhythms (bradyarrhythmias) occur primarily 31 at night. Although the lower heart rate at night is widely assumed to be neural in origin (the result 32 of high vagal tone), the objective of the study was to test whether there is an intrinsic change in 33 heart rate driven by a local circadian clock. In the mouse, there was a circadian rhythm in the heart 34 rate in vivo in the conscious telemetrized animal, but there was also a circadian rhythm in the 35 intrinsic heart rate in denervated preparations: the Langendorff-perfused heart and isolated sinus 36 node. In the sinus node, experiments (qPCR and bioluminescence recordings in mice with a Per1 37 luciferase reporter) revealed functioning canonical clock genes, e.g. Bmal1 and Per1. We identified 38 a circadian rhythm in the expression of key ion channels, notably the pacemaker channel Hcn4 39 (mRNA and protein) and the corresponding ionic current (funny current, measured by whole cell 40 patch clamp in isolated sinus node cells). Block of funny current in the isolated sinus node 41 abolished the circadian rhythm in the intrinsic heart rate. Incapacitating the local clock (by cardiac-42 specific knockout of Bmal1) abolished the normal circadian rhythm of Hcn4, funny current and the 43 intrinsic heart rate. Chromatin immunoprecipitation demonstrated that Hcn4 is a transcriptional 44 target of BMAL1 establishing a pathway by which the local clock can regulate heart rate. In 45 conclusion, there is a circadian rhythm in the intrinsic heart rate as a result of a local circadian 46 clock in the sinus node that drives rhythmic expression of Hcn4. The data reveal a novel regulator 47 of heart rate and mechanistic insight into the occurrence of bradyarrhythmias at night. 483 Living things including humans are attuned to the 24 h day-night cycle and many biological 49 processes exhibit an intrinsic ~24 h (i.e. circadian) rhythm. In the human, the resting heart rate (in 50 the absence of physical activity) shows a circadian rhythm and is higher during the day when we 51 are awake 1,2 . The heart is therefore primed, anticipating the increase in demand during the awake 52 period. Conversely, bradyarrhythmias primarily occur at night 1,3 . Previously, the circadian rhythm in 53 heart rate in vivo has been attributed to the autonomic nervous system: to high sympathetic nerve 54 activity accompanying physical activity during the awake period and high vagal tone during the 55 sleep period 4 . This is partly based on heart rate variability as a surrogate measure of autonomic 56 tone 5-7 ; however, we have shown that heart rate variability cannot be used in any simple way as a 57 measure of autonomic tone 8 . Therefore, the mechanism underlying the circadian rhythm in heart 58 rate is still unknown. We asked the question whether there is a circadian rhythm in the intrinsic 59 heart rate set by the pacemaker of the he...

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“…6 The similarity in the average nocturnal blood pressure dip between the in-hospital and out-patient measurements (−9/−7 and −8/−8 mm Hg respectively) suggests that the environment has little or no influence on the circadian variation in blood pressure in this population. The normal nocturnal blood pressure decline has been reported to be attenuated or abolished after heart transplantation, [7][8][9] although the diurnal rhythm may be restored after a variable period of time and to a variable extent in some patients. 10,11 It is therefore not surprising to find in the present study population an average nocturnal dip which is less than that in a general population of normotensives (−16/−14 mm Hg) or hypertensives (−19/−14 mm Hg).…”

Section: H Daytime Night-timementioning

confidence: 99%

Out-patient versus in-hospital ambulatory 24-h blood pressure monitoring in heart transplant recipients

et al. 1999

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Objective: To study the effect of the environment-inhospital vs out-patient situation-on blood pressure as measured by ambulatory blood pressure monitoring (ABPM). Patients and methods: Twenty-four hour ABPM was performed sequentially in-hospital and again 9 ± 3 days later on an out-patient basis, in 30 consecutive heart transplant recipients (27 men, median age 56 years, median time post-transplant 3 years). The same equipment was used on both occasions, without any interim change in medical treatment. Results: Both systolic and diastolic blood pressure were higher in-hospital than as an out-patient: +7 ± 7 and +6 ± 5 mm Hg respectively for the 24-h average (P Ͻ 0.001). Daytime and night-time pressures were

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Decreased circadian blood pressure variation up to three years after heart transplantation

Cited by 11 publications

References 12 publications

Hypertension in thoracic transplant recipients

Hypertension in thoracic transplant recipients

Circadian control of intrinsic heart rate via a sinus node clock and the pacemaker channel

Out-patient versus in-hospital ambulatory 24-h blood pressure monitoring in heart transplant recipients

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