Staying up late induces abnormal heart rhythm and increases the risk of sudden cardiac death | 熬夜诱发心律异常,增加心源性猝死风险

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It has been long known that staying up late can cause a series of health conditions including but not limited to immune dysfunction, rough skin, and disturbance of the body’s biological clock.  A new study of night shift workers in Cambridge, UK shows that frequently working night shifts disturbs the biological clock and induces abnormal heart rhythms, a type of cardiac dysfunction.

The study conducted by a research team from the Molecular Biology Laboratory of the Cambridge Medical Research Council in the UK shows that staying up late may cause an abnormal circadian rhythm in heart cells increasing the risk of adverse events such as arrhythmia and sudden cardiac death.

The circadian rhythm gives human behavior and physiology the time pattern so that the body’s internal and external environment is consistent with the expected changes.  When the circadian rhythm is disturbed, the heart does not work, according to human behavior.  Early studies have already shown that staying up late increases the risk of metabolic disorders, cardiovascular disease, mental illness, and cancer.

The study’s corresponding author and molecular biologist, Dr. John O’Neill, said: “Many life-threatening heart problems occur at specific times of the day, and more often occur in shift workers.

“The way the heart function changes day and night is much more complicated than we previously thought. When the heart’s biological clock is out of touch with the brain’s biological clock, our cardiovascular system may not be able to cope with the functional demands under the pressure of daily work, which may make the heart easier There is a dysfunction.”

In this study, the researchers proved for the first time that heart cells regulate their circadian rhythm through changes in the concentrations of sodium and potassium ions in the cells.  Different concentrations of sodium and potassium ions inside and outside the heart cells cause electrical impulses to regulate heart contraction and drive the heartbeat.

Cell ion concentration is generally considered stable.  But researchers have found heart cells actually change their internal sodium and potassium concentrations during the day and night to adapt to our needs, allowing the heart to adapt better when we are active and maintain an increased heart rate.

For healthy people, countless cell clocks in the body coordinate and synchronize with each other. The study found that the brain adapts quickly during shifts, but there is a lag in the biological clock of every cell in the heart. The signals sent by the brain are out of sync with the expectations of the heart for a few days. It will increase the risk of various heart diseases, especially during the shift from day to night.

In this study, the discovery of the autonomic circadian rhythm of heart cells provides a new explanation for the cause of arrhythmia. During the night shift, the difference in potassium ion concentration on both sides of the human heart cell membrane becomes larger, and the excitability is poor. It may not be able to respond to the high-intensity excitatory signal from the nervous system, and therefore, arrhythmia occurs.

The researchers said that this study has important clinical value, because lifestyle factors (such as staying up late or shift work) caused by circadian clock disturbances are related to the increased incidence of many diseases, including arrhythmia and other heart diseases. The research also opens up new possibilities for effective treatment of cardiovascular diseases, such as choosing the right time of day to administer drugs.

Dr. O’Neill told the British Broadcasting Corporation (BBC) that there is no pill that can reset the body clock with just one pill. But he suggested that if you shift from the day shift to the night shift, you need to change your daily life throughout the day and stick to this change before starting the first night of the night shift. This will help to adapt faster and avoid many side effects.

The research results have been published in the journal Nature.

眾所周知,熬夜會導致一系列健康狀況,包括但不限於免疫功能障礙、皮膚粗糙、生物鐘紊亂等。一項針對英國劍橋夜班工人的新研究表明,頻繁的夜班工作會擾亂生物鐘並誘發心律失常,這是一種心臟功能障礙。

英國劍橋醫學研究委員會分子生物學實驗室的一個研究小組進行的研究表明,熬夜可能會導致心臟細胞晝夜節律異常,增加發生心律失常和心源性猝死等不良事件的風險。

晝夜節律賦予人類行為和生理時間模式,使身體的內外環境與預期的變化保持一致。根據人類的行為,當晝夜節律受到干擾時,心臟就不會工作。早期研究已經表明,熬夜會增加代謝紊亂、心血管疾病、精神疾病和癌症的風險。

該研究的通訊作者和分子生物學家約翰奧尼爾博士說:“許多危及生命的心臟問題發生在一天中的特定時間,而且更常見於輪班工人。

“心臟功能日夜變化的方式比我們之前想像的要復雜得多。當心臟的生物鐘與大腦的生物鐘脫節時,我們的心血管系統可能無法應對壓力下的功能需求日常工作,這可能會使心臟更容易出現功能障礙。”

在這項研究中,研究人員首次證明心臟細胞通過改變細胞內鈉離子和鉀離子濃度來調節其晝夜節律。心臟細胞內外不同濃度的鈉離子和鉀離子會產生電脈衝來調節心臟收縮並驅動心跳。

細胞離子濃度通常被認為是穩定的。但研究人員發現,心臟細胞實際上會在白天和黑夜改變其內部鈉和鉀的濃度以適應我們的需要,當我們活躍時心臟能夠更好地適應並保持增加的心率。

對於健康的人來說,體內無數的細胞時鐘相互協調和同步。研究發現,大腦在輪班時適應很快,但心臟中每個細胞的生物鐘都有滯後。幾天來,大腦發出的信號與心臟的預期不同步。它會增加患各種心髒病的風險,尤其是在從白天到黑夜的輪班期間。

在這項研究中,心臟細胞自主晝夜節律的發現為心律失常的原因提供了新的解釋。夜班期間,人體心臟細胞膜兩側鉀離子濃度差異變大,興奮性差。它可能無法對來自神經系統的高強度興奮信號做出反應,從而發生心律失常。

研究人員表示,這項研究具有重要的臨床價值,因為生物鐘紊亂引起的生活方式因素(如熬夜或輪班工作)與許多疾病的發病率增加有關,包括心律失常和其他心髒病。該研究還為有效治療心血管疾病開闢了新的可能性,例如選擇一天中的正確給藥時間。

奧尼爾博士告訴英國廣播公司 (BBC),沒有任何藥片可以只用一顆藥片就可以重置生物鐘。但他建議,如果你從白班換到夜班,你需要全天改變你的日常生活,並在開始第一個夜班之前堅持這個改變。這將有助於更快地適應並避免許多副作用。

研究結果已發表在《自然》雜誌上。

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