Short communication: ischemia/reperfusion tolerance is time-of-day-dependent: mediation by the cardiomyocyte circadian clock

Circ Res. 2010 Feb 19;106(3):546-50. doi: 10.1161/CIRCRESAHA.109.209346. Epub 2009 Dec 10.


Rationale: Cardiovascular physiology and pathophysiology vary dramatically over the course of the day. For example, myocardial infarction onset occurs with greater incidence during the early morning hours in humans. However, whether myocardial infarction tolerance exhibits a time-of-day dependence is unknown.

Objective: To investigate whether time of day of an ischemic insult influences clinically relevant outcomes in mice.

Methods and results: Wild-type mice were subjected to ischemia/reperfusion (I/R) (45 minutes of ischemia followed by 1 day or 1 month of reperfusion) at distinct times of the day, using the closed-chest left anterior descending coronary artery occlusion model. Following 1 day of reperfusion, hearts subjected to ischemia at the sleep-to-wake transition (zeitgeber time [ZT]12) resulted in 3.5-fold increases in infarct size compared to hearts subjected to ischemia at the wake-to-sleep transition (ZT0). Following 1 month of reperfusion, prior ischemic event at ZT12 versus ZT0 resulted in significantly greater infarct volume, fibrosis, and adverse remodeling, as well as greater depression of contractile function. Genetic ablation of the cardiomyocyte circadian clock (termed cardiomyocyte-specific circadian clock mutant [CCM] mice) attenuated/abolished time-of-day variations in I/R outcomes observed in wild-type hearts. Investigation of Akt and glycogen synthase kinase-3beta in wild-type and CCM hearts identified these kinases as potential mechanistic ties between the cardiomyocyte circadian clock and I/R tolerance.

Conclusions: We expose a profound time-of-day dependence for I/R tolerance, which is mediated by the cardiomyocyte circadian clock. Further understanding of I/R tolerance rhythms will potentially provide novel insight regarding the etiology and treatment of ischemia-induced cardiac dysfunction.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • ARNTL Transcription Factors / biosynthesis
  • ARNTL Transcription Factors / genetics
  • Animals
  • Basic-Leucine Zipper Transcription Factors / biosynthesis
  • Basic-Leucine Zipper Transcription Factors / genetics
  • Circadian Rhythm / genetics
  • Circadian Rhythm / physiology*
  • DNA-Binding Proteins / biosynthesis
  • DNA-Binding Proteins / genetics
  • Gene Expression Regulation / physiology
  • Glycogen Synthase Kinase 3 / genetics
  • Glycogen Synthase Kinase 3 / physiology*
  • Glycogen Synthase Kinase 3 beta
  • Male
  • Mice
  • Mice, Mutant Strains
  • Myocardial Infarction / enzymology
  • Myocardial Infarction / pathology
  • Myocardial Infarction / physiopathology*
  • Myocardial Reperfusion Injury / enzymology
  • Myocardial Reperfusion Injury / pathology
  • Myocardial Reperfusion Injury / physiopathology*
  • Myocytes, Cardiac / enzymology
  • Myocytes, Cardiac / physiology*
  • Phosphorylation
  • Phosphoserine / analysis
  • Protein Processing, Post-Translational
  • Recovery of Function
  • Sleep / physiology
  • Time Factors
  • Transcription Factors / biosynthesis
  • Transcription Factors / genetics
  • Wakefulness / physiology


  • ARNTL Transcription Factors
  • Arntl protein, mouse
  • Basic-Leucine Zipper Transcription Factors
  • DNA-Binding Proteins
  • Dbp protein, mouse
  • Nfil3 protein, mouse
  • Transcription Factors
  • Phosphoserine
  • GSK3B protein, human
  • Glycogen Synthase Kinase 3 beta
  • Gsk3b protein, mouse
  • Glycogen Synthase Kinase 3