Sudden cardiac death (SCD) is the sudden, unexpected death due to abrupt loss of heart function secondary to cardiovascular disease. In certain populations living with cardiovascular disease, SCD follows a distinct 24-hour pattern in occurrence, suggesting day/night rhythms in behavior, the environment, and endogenous circadian rhythms result in daily spans of increased vulnerability. The National Heart, Lung, and Blood Institute convened a workshop, Understanding Circadian Mechanisms of Sudden Cardiac Death to identify fundamental questions regarding the role of the circadian rhythms in SCD. Part 2 summarizes research gaps and opportunities in the areas of population and clinical research identified in the workshop. Established research supports a complex interaction between circadian rhythms and physiological responses that increase the risk for SCD. Moreover, these physiological responses themselves are influenced by several biological variables, including the type of cardiovascular disease, sex, age, and genetics, as well as environmental factors. The emergence of new noninvasive biotechnological tools that continuously measure key cardiovascular variables, as well as the identification of biomarkers to assess circadian rhythms, hold promise for generating large-scale human data sets that will delineate which subsets of individuals are most vulnerable to SCD. Additionally, these data will improve our understanding of how people who suffer from circadian disruptions develop cardiovascular diseases that increase the risk for SCD. Emerging strategies to identify new biomarkers that can quantify circadian health (eg, environmental, behavioral, and internal misalignment) may lead to new interventions and therapeutic targets to prevent the progression of cardiovascular diseases that cause SCD.

中文翻译：

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了解心源性猝死的昼夜节律机制：来自国家心肺血液研究所研讨会的报告，第 2 部分：人群和临床考虑

心源性猝死 (SCD) 是由于心血管疾病继发的心脏功能突然丧失而导致的突然、意外死亡。在某些患有心血管疾病的人群中，SCD 遵循明显的 24 小时发生模式，这表明行为、环境和内源性昼夜节律的昼夜节律导致每天的脆弱性增加。国家心脏、肺和血液研究所召开了一个研讨会，了解心脏猝死的昼夜节律机制，以确定有关昼夜节律在 SCD 中的作用的基本问题。第 2 部分总结了研讨会确定的人口和临床研究领域的研究差距和机遇。已建立的研究支持昼夜节律和增加 SCD 风险的生理反应之间的复杂相互作用。此外，这些生理反应本身受到多种生物学变量的影响，包括心血管疾病的类型、性别、年龄和遗传学，以及环境因素。持续测量关键心血管变量的新型非侵入性生物技术工具的出现，以及用于评估昼夜节律的生物标志物的鉴定，有望生成大规模人类数据集，这些数据集将描述哪些个体亚群最容易受到 SCD 的影响。此外，这些数据将提高我们对遭受昼夜节律紊乱的人如何发展为增加 SCD 风险的心血管疾病的理解。