Whether or not genes that regulate circadian rhythm modulate cell death directly and affect ischemia injury or reperfusion injury is still unclear. However, a recent study has clearly shown that circadian rhythm is of clinical importance in aortic-valve replacement surgery. In an observational cohort of 298 matched pairs, the relative risk of major adverse cardiac events was halved in patients who underwent on-pump valve-replacement surgery in the afternoon rather than in the morning (hazard ratio 0.50; P=0.0021). Can a well-timed aortic valve surgery and circadian rhythm help in better outcomes?
Source: Montaigne D, Marechal X, Modine T, et al. Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-Erbα antagonism: A single-center propensity-matched cohort study and a randomized study. Lancet 2017.
