In Reply

We appreciate the interest of Lagieret al. in our article.1 The authors highlighted in their letter the work of Montaigneet al.,2 who have recently published on the circadian rhythm in relation to ischemia reperfusion injury in a single-center retrospective propensity-matched cohort study addressing this subject on 596 (matched-pairs) patients undergoing aortic valve replacement with or without coronary artery bypass grafting, together with a single-center randomized study in 88 patients undergoing isolated aortic valve replacement, in which the perioperative myocardial injury has been assessed with the geometric mean of perioperative cardiac troponin T release. Together with these reported studies these authors also reported in the same article on anex vivo analysis of the human myocardium that showed an intrinsic morning afternoon variation concomitant with a circadian variation of Rev-Erb α. An accompanying comment noticed that gene-expression analysis, mainly performed in rodents, had shown in the early 2000s a rhythmic expression of clock genes in the heart3; whether or not clock genes modulate cell death directly and whether they affect ischemia reperfusion injury remained to be established, even after the publication of Montaigne.4
Source: Anesthesiology - Category: Anesthesiology Source Type: research