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Journal of Chinese Integrative Medicine ›› 2005, Vol. 3 ›› Issue (5): 355-358.doi: 10.3736/jcim20050505

• Original Clinical Research • Previous Articles     Next Articles

Study on pathological rhythm of traditional Chinese medicine about circadian distribution of premature ventricular contractions in 240 patients with viral myocarditis

Song Cui1,Xin-lin Chen2,Mei-xian Jiang1   

  1. 1. Department of Cardiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China
    2. Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
  • Received:2005-06-20 Online:2005-09-20 Published:2005-09-20
  • Contact: Mei-xian Jiang E-mail:jmxzgx@medmail.com.cn

Objective

To explore the circadian distribution of premature ventricular contractions (PVCs) in patients with viral myocarditis (VM) according to the theory of chronomedicine in traditional Chinese medicine (TCM) in order to find out the scientific evidence for a reasonable administration time.

Methods

Two hundred and forty patients with VM were enrolled and electrocardiograms were examined for all by Holter monitor. The circadian distribution of PVCs was evaluated according to the theory of chronomedicine of TCM about time periods corresponding to five zang viscera.

Results

PVCs mostly happened in periods of 3∶00-5∶00, 5∶00-7∶00, 7∶00-9∶00 and 9∶00-11∶00, in which 5∶00-7∶00 was the most serious time. Less PVCs happened in periods of 17∶00-19∶00, 19∶00-21∶00 and 21∶00-23∶00. The frequency of PVCs in midnight also increased with aging. The time periods of the frequency peak of PVCs in patients with different syndromes were also different. In patients with syndrome of pathogenic heat invading heart (PHIH), the PVCs mostly appeared in midday. In patients with syndrome of flaring of fire due to yin-deficiency (FFYD), the PVCs were most serious in daytime and aggravated at noon. And in patients with syndrome of insufficiency of heart-qi and yang (IHQY), the PVCs mostly happened in early morning or midnight.

Conclusion

There was a manifest regulation of the pathological circadian rhythm of PVCs in patients with VM. The circadian distributions of PVCs were variable in patients with different syndromes. Therefore the theory of chronomedicine of TCM may be used to guide the treatment based on syndrome differentiation.

Key words: Circadian rhythm, Myocarditis, Ventricular premature complexs

CLC Number: 

  • R226.4

Tab 1

Circadian distribution of peak frequency of PVCs in patients with viral myocarditis in groups of different ages (to be continued) [Cases (%)]"

Group n Circadian distribution of peak frequency in different time periods
23∶00-1∶00 1∶00-3∶00 3∶00-5∶00 5∶00-7∶00 7∶00-9∶00 9∶00-11∶00
<30 years 53 2 (3.77) 2 (3.77) 12(22.64) 10 (18.87) 9 (16.98) 8 (15.09)
30-39 years 80 9 (11.25) 9 (11.25) 8 (10.00) 15 (18.75) 5 (6.25) 12 (15.00)
40-50 years 107 10 (9.35) 15 (14.02*) 11 (10.28) 23(21.50) 13 (12.15) 13 (12.15)
Total 240 21 (8.75) 26 (10.83) 31 (12.92) 48 (20.00) 27 (11.25) 33 (13.75)
Group n Circadian distribution of peak frequency in different time periods
11∶00-13∶00 13∶00-15∶00 15∶00-17∶00 17∶00-19∶00 19∶00-21∶00 21∶00-23∶00
<30 years 53 4 (7.54) 3 (5.66) 1 (1.89) 1 (1.89) 1 (1.89) 0 (0)
30-39 years 80 8 (10.00) 5 (6.25) 4 (5.00) 1 (1.25) 2 (2.50) 2 (2.50)
40-50 years 107 9 (8.41) 4 (3.74) 2 (1.87) 2 (1.87) 2 (1.87) 3 (2.80)
Total 240 21 (8.75) 12 (5.00) 7 (2.92) 4 (1.67) 5 (2.08) 5 (2.08)

Tab 2

Relationships between circadian distribution of peak frequency of PVCs in patients with viral myocarditis and corresponding five zang viscera in groups of different ages [Cases (%)]"

Group n Circadian distribution of peak frequency in different time periods (corresponding zang viscera)
3∶00-9∶00
(liver)
9∶00-15∶00
(heart)
13∶00-17∶00
(spleen)
15∶00-23∶00
(lung)
21∶00-3∶00
(kidney)
<30 years 53 31 (54.39*) 15 (26.32) 4 (7.02) 3 (5.26) 4 (7.02)
30-39 years 80 28 (31.46) 25 (28.09) 9 (10.11) 7 (7.87) 20 (22.47)
40-50 years 107 47 (41.59*) 26 (23.01) 6 (5.31) 6 (5.31) 28 (24.78)
Total 240 106 (40.93) 66 (25.48) 19 (7.34) 16 (6.18) 52 (20.08)

Tab 3

Relationships between circadian distribution of peak frequency of PVCs in patients with viral myocarditis and five zang viscera in groups of different syndromes[Cases (%)]"

Group n Circadian distribution of peak frequency in different time periods (corresponding zang viscera)
3∶00-9∶00
(liver)
9∶00-15∶00
(heart)
13∶00-17∶00
(spleen)
15∶00-23∶00
(lung)
21∶00-3∶00
(kidney)
PHIP 20 4 (18.18) 13 (59.09*) 2 (9.09) 2 (9.09) 1 (4.55)
FFYD 20 1 (4.00) 11 (44.00*) 5 (20.00) 5 (20.00) 3 (12.00)
IHQY 20 8 (38.10△) 2 (9.52) 1 (4.76) 2 (9.52) 8 (38.10)
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