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British Heart Journal logoLink to British Heart Journal
. 1990 Dec;64(6):388–392. doi: 10.1136/hrt.64.6.388

Circadian variation of heart rate is affected by environment: a study of continuous electrocardiographic monitoring in members of a symphony orchestra.

D Mulcahy 1, J Keegan 1, A Fingret 1, C Wright 1, A Park 1, J Sparrow 1, D Curcher 1, K M Fox 1
PMCID: PMC1224817  PMID: 2271347

Abstract

Twenty four hour ambulatory ST segment monitoring was performed on 48 members (43 players and five members of the management/technical team) of the British Broadcasting Corporation (BBC) symphony orchestra without a history of cardiac disease. This period included final rehearsals and live performances (for audience and radio) of music by Richard Strauss and Mozart at the Royal Festival Hall (n = 36) and Rachmaninov and Tchaikovsky at the Barbican Arts Centre (n = 21). During the period of monitoring one person (2%) had transient ST segment changes. Mean heart rates were significantly higher during the live performances than during the rehearsals. Mean heart rates during the live performance of Rachmaninov and Tchaikovsky were significantly higher than during Strauss and Mozart in those (n = 6) who were monitored on both occasions. Mean heart rates in the management and technical team were higher than those of the players. The recognised circadian pattern of heart rate, with a peak in the morning waking hours, was altered similarly during both concert days, with a primary peak occurring in the evening hours and a lesser peak in the morning for both musicians and management/technical staff. This study showed that environmental factors are of primary importance in defining the circadian pattern of heart rate. This has important implications when identifying peak periods of cardiovascular stress and tailoring drug treatment for patients with angina pectoris.

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Selected References

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  1. Alpert J. S. The patient with angina: the importance of careful listening. J Am Coll Cardiol. 1988 Jan;11(1):27–27. doi: 10.1016/0735-1097(88)90161-1. [DOI] [PubMed] [Google Scholar]
  2. Angleton P., Chandler W. L., Schmer G. Diurnal variation of tissue-type plasminogen activator and its rapid inhibitor (PAI-1). Circulation. 1989 Jan;79(1):101–106. doi: 10.1161/01.cir.79.1.101. [DOI] [PubMed] [Google Scholar]
  3. Assey M. E., Walters G. L., Hendrix G. H., Carabello B. A., Usher B. W., Spann J. F., Jr Incidence of acute myocardial infarction in patients with exercise-induced silent myocardial ischemia. Am J Cardiol. 1987 Mar 1;59(6):497–500. doi: 10.1016/0002-9149(87)91155-6. [DOI] [PubMed] [Google Scholar]
  4. Egstrup K. Randomized double-blind comparison of metoprolol, nifedipine, and their combination in chronic stable angina: effects on total ischemic activity and heart rate at onset of ischemia. Am Heart J. 1988 Oct;116(4):971–978. doi: 10.1016/0002-8703(88)90147-0. [DOI] [PubMed] [Google Scholar]
  5. Fujita M., Franklin D. Diurnal changes in coronary blood flow in conscious dogs. Circulation. 1987 Aug;76(2):488–491. doi: 10.1161/01.cir.76.2.488. [DOI] [PubMed] [Google Scholar]
  6. Gibbons R. J., Fyke F. E., 3rd, Clements I. P., Lapeyre A. C., 3rd, Zinsmeister A. R., Brown M. L. Noninvasive identification of severe coronary artery disease using exercise radionuclide angiography. J Am Coll Cardiol. 1988 Jan;11(1):28–34. doi: 10.1016/0735-1097(88)90162-3. [DOI] [PubMed] [Google Scholar]
  7. Imperi G. A., Lambert C. R., Coy K., Lopez L., Pepine C. J. Effects of titrated beta blockade (metoprolol) on silent myocardial ischemia in ambulatory patients with coronary artery disease. Am J Cardiol. 1987 Sep 1;60(7):519–524. doi: 10.1016/0002-9149(87)90297-9. [DOI] [PubMed] [Google Scholar]
  8. Kohli R. S., Cashman P. M., Lahiri A., Raftery E. B. The ST segment of the ambulatory electrocardiogram in a normal population. Br Heart J. 1988 Jul;60(1):4–16. doi: 10.1136/hrt.60.1.4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. MASTER A. M. The role of effort and occupation (including physicians) in coronary occlusion. JAMA. 1960 Oct 22;174:942–948. doi: 10.1001/jama.1960.03030080004002. [DOI] [PubMed] [Google Scholar]
  10. Millar-Craig M. W., Bishop C. N., Raftery E. B. Circadian variation of blood-pressure. Lancet. 1978 Apr 15;1(8068):795–797. doi: 10.1016/s0140-6736(78)92998-7. [DOI] [PubMed] [Google Scholar]
  11. Muller J. E., Ludmer P. L., Willich S. N., Tofler G. H., Aylmer G., Klangos I., Stone P. H. Circadian variation in the frequency of sudden cardiac death. Circulation. 1987 Jan;75(1):131–138. doi: 10.1161/01.cir.75.1.131. [DOI] [PubMed] [Google Scholar]
  12. Muller J. E., Stone P. H., Turi Z. G., Rutherford J. D., Czeisler C. A., Parker C., Poole W. K., Passamani E., Roberts R., Robertson T. Circadian variation in the frequency of onset of acute myocardial infarction. N Engl J Med. 1985 Nov 21;313(21):1315–1322. doi: 10.1056/NEJM198511213132103. [DOI] [PubMed] [Google Scholar]
  13. Muller J. E., Tofler G. H., Stone P. H. Circadian variation and triggers of onset of acute cardiovascular disease. Circulation. 1989 Apr;79(4):733–743. doi: 10.1161/01.cir.79.4.733. [DOI] [PubMed] [Google Scholar]
  14. Northcote R. J., Canning G. P., Ballantyne D. Electrocardiographic findings in male veteran endurance athletes. Br Heart J. 1989 Feb;61(2):155–160. doi: 10.1136/hrt.61.2.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Peters R. W., Muller J. E., Goldstein S., Byington R., Friedman L. M. Propranolol and the morning increase in the frequency of sudden cardiac death (BHAT Study). Am J Cardiol. 1989 Jun 15;63(20):1518–1520. doi: 10.1016/0002-9149(89)90019-2. [DOI] [PubMed] [Google Scholar]
  16. Quyyumi A. A., Crake T., Wright C. M., Mockus L. J., Fox K. M. Medical treatment of patients with severe exertional and rest angina: double blind comparison of beta blocker, calcium antagonist, and nitrate. Br Heart J. 1987 Jun;57(6):505–511. doi: 10.1136/hrt.57.6.505. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Quyyumi A. A., Mockus L., Wright C., Fox K. M. Morphology of ambulatory ST segment changes in patients with varying severity of coronary artery disease. Investigation of the frequency of nocturnal ischaemia and coronary spasm. Br Heart J. 1985 Feb;53(2):186–193. doi: 10.1136/hrt.53.2.186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Quyyumi A. A., Wright C., Fox K. Ambulatory electrocardiographic ST segment changes in healthy volunteers. Br Heart J. 1983 Nov;50(5):460–464. doi: 10.1136/hrt.50.5.460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Rocco M. B., Barry J., Campbell S., Nabel E., Cook E. F., Goldman L., Selwyn A. P. Circadian variation of transient myocardial ischemia in patients with coronary artery disease. Circulation. 1987 Feb;75(2):395–400. doi: 10.1161/01.cir.75.2.395. [DOI] [PubMed] [Google Scholar]
  20. Sharma B., Asinger R., Francis G. S., Hodges M., Wyeth R. P. Demonstration of exercise-induced painless myocardial ischemia in survivors of out-of-hospital ventricular fibrillation. Am J Cardiol. 1987 Apr 1;59(8):740–745. doi: 10.1016/0002-9149(87)91084-8. [DOI] [PubMed] [Google Scholar]
  21. Tofler G. H., Brezinski D., Schafer A. I., Czeisler C. A., Rutherford J. D., Willich S. N., Gleason R. E., Williams G. H., Muller J. E. Concurrent morning increase in platelet aggregability and the risk of myocardial infarction and sudden cardiac death. N Engl J Med. 1987 Jun 11;316(24):1514–1518. doi: 10.1056/NEJM198706113162405. [DOI] [PubMed] [Google Scholar]
  22. Turton M. B., Deegan T. Circadian variations of plasma catecholamine, cortisol and immunoreactive insulin concentrations in supine subjects. Clin Chim Acta. 1974 Sep 30;55(3):389–397. doi: 10.1016/0009-8981(74)90014-x. [DOI] [PubMed] [Google Scholar]
  23. Uusitalo A., Arstila M., Bae E. A., Härkönen R., Keyriläinen O., Rytkönen U., Schjelderup-Mathiesen P. M., Wendelin H. Metoprolol, nifedipine, and the combination in stable effort angina pectoris. Am J Cardiol. 1986 Apr 1;57(10):733–737. doi: 10.1016/0002-9149(86)90604-1. [DOI] [PubMed] [Google Scholar]
  24. Willich S. N., Levy D., Rocco M. B., Tofler G. H., Stone P. H., Muller J. E. Circadian variation in the incidence of sudden cardiac death in the Framingham Heart Study population. Am J Cardiol. 1987 Oct 1;60(10):801–806. doi: 10.1016/0002-9149(87)91027-7. [DOI] [PubMed] [Google Scholar]
  25. Willich S. N., Pohjola-Sintonen S., Bhatia S. J., Shook T. L., Tofler G. H., Muller J. E., Curtis D. G., Williams G. H., Stone P. H. Suppression of silent ischemia by metoprolol without alteration of morning increase of platelet aggregability in patients with stable coronary artery disease. Circulation. 1989 Mar;79(3):557–565. doi: 10.1161/01.cir.79.3.557. [DOI] [PubMed] [Google Scholar]

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