Papel del ritmo circadiano en el infarto agudo de miocardio.

Role of circadian rhythm in acute myocardial infarction.

Múltiples investigaciones evidencian una alta incidencia del infarto agudo de miocardio en horas de la mañana. El objetivo de este artículo es revisar la organización del sistema circadiano, su importancia en la fisiología del sistema cardiovascular y su relación con el desarrollo del infarto agudo de miocardio. Se realizó una búsqueda bibliográfica en diversas bases de datos para identificar artículos publicados durante los últimos 20 años, centrados en la variación circadiana del infarto agudo de miocardio y en la cronoterapia cardiovascular. Se preseleccionaron 115 artículos, de los cuales se escogieron 60. Se concluyó que la mayor incidencia matutina del infarto agudo de miocardio se explica por la acción conjunta de factores endógenos (aumento matutino de cortisol, catecolaminas, presión arterial, frecuencia cardíaca, resistencias vasculares) y exógenos (alteración en el ciclo sueño-vigilia, bipedestación e inicio de la actividad), que predispone al organismo a ruptura de la placa ateromatosa y a la aparición de episodios trombóticos durante la mañana. [ABSTRACT FROM AUTHOR]

Multiple investigations show a maximum incidence of acute myocardial infarction in the morning. The objective of this article is to review the organization of the circadian system, its importance in the physiology of the cardiovascular system and its relationship with the development of acute myocardial infarction. A bibliographic search was carried out in different databases to identify articles published during the last 20 years, focused on the circadian variation of acute myocardial infarction and on cardiovascular chronotherapy. 115 articles were preselected, of which 60 were chosen. It was concluded that the higher morning incidence of acute myocardial infarction is explained by the joint action of endogenous factors (morning increase in cortisol, catecholamines, blood pressure, heart rate, vascular resistance) and exogenous (alteration in the sleep-wake cycle, standing, and onset of activity) that predisposes to rupture of the atheromatous plaque and the appearance of thrombotic episodes during the morning. [ABSTRACT FROM AUTHOR]

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