The relevance of the brain in the diseased heart: Authors' response

摘要

In their comment to our recent paper entitled "Stressed Brain, Diseases Heart: A review on the pathophysiologic mechanisms of neurocardiology." [1], Dominguez-Rodriguez and Abreu-Gonzalez [2] emphasize the relevance of circadian rhythm in cardiovascular diseases and propose the suprachiasmatic nucleus and melatonin as key mediators in its pathophysiology. We found this a very interesting observation. The incidence of acute myocardial infarction [3] and its extension [4] displays a circadian pattern usually pealdng in early morning. Whether this is a consequence of the oscillating levels of circulating hormones or from a direct action of central mechanisms on the heart and vessels themselves is still a matter of dispute.In addition to melatonin, also cortisol has been implicated in the circadian variation of cardiovascular diseases. Cortisol is produced by the adrenal glands following a circadian pattern with the zenith 1 h before awakening.