Evidence map›Paper›PMID 33278629›Full record

ArticleHeart rhythm2021

A circadian clock in the sinus node mediates day-night rhythms in Hcn4 and heart rate.

Alicia D'Souza, Yanwen Wang, Cali Anderson, Annalisa Bucchi, Mirko Baruscotti, Servé Olieslagers, Pietro Mesirca, Anne Berit Johnsen, Svetlana Mastitskaya, Haibo Ni and 20 more

Open access · hybridAbstract read
In one paragraph

Article in Heart rhythm, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 95 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Twenty-Four Hour Rhythms in Cardiovascular Physiology.Acta physiologica (Oxford, England) · 2025
    Review
  6. Article
  7. Article
  8. Circadian rhythms in cardiovascular disease.European heart journal · 2025
    Review
  9. Article
  10. Article
  11. Review
  12. Effect ofInternational journal of molecular sciences · 2025
    Review
  13. Review
  14. Circadian influences on sudden cardiac death and cardiac electrophysiology.Journal of molecular and cellular cardiology · 2025
    Review
  15. Review
  16. Review
  17. Feeding behavior modifies the circadian variation in RR and QT intervals by distinct mechanisms in mice.American journal of physiology. Regulatory, integrative and comparative physiology · 2024
    Article
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors at 9 institutions in 7 countries.

Alicia D'SouzaDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom. Electronic address: alicia.dsouza@manchester.ac.uk.
Yanwen WangDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Cali AndersonDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Annalisa BucchiDepartment of Biosciences, University of Milan, Milan, Italy.
Mirko BaruscottiDepartment of Biosciences, University of Milan, Milan, Italy.
Servé OlieslagersDepartment of Cardiology, Maastricht University, Maastricht, The Netherlands.
Pietro MesircaInstitut de Génomique Fonctionnelle, Université de Montpellie, CNRS, Montpellier, France.
Anne Berit JohnsenDepartment of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Svetlana MastitskayaNeuroscience, Physiology and Pharmacology, University College London, London, United Kingdom.
Haibo NiDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Yu ZhangDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Nicholas BlackDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Charlotte CoxDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Sven WegnerDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Beatriz Bano-OtaloraDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Cheryl PetitDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Eleanor GillDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Sunil Jit R J LoganthaDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; Liverpool Centre for Cardiovascular Sciences, University of Liverpool, Liverpool, UK.
Halina DobrzynskiDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Nick AshtonDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
George HartDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Rai ZhangSchool of Civil, Aerospace and Mechanical Engineering, University of Bristol, Bristol, United Kingdom.
Henggui ZhangDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Elizabeth J CartwrightDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
Ulrik WisloffDepartment of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Matteo E MangoniDepartment of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Paula A da Costa MartinsDepartment of Cardiology, Maastricht University, Maastricht, The Netherlands.
Hugh D PigginsSchool of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, United Kingdom.
Dario DiFrancescoDepartment of Biosciences, University of Milan, Milan, Italy; IBF-CNR, Milan, Italy.
Mark R BoyettDivision of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
University of Manchester · GBUniversity of Milan · ITMaastricht University · NLNorwegian University of Science and Technology · NOUniversity of Bristol · GBUniversity of Copenhagen · DKCentre National de la Recherche Scientifique · FRUniversity College London · GBUniversity of Liverpool · GB

Funding

Biotechnology and Biological Sciences Research Council BB/J003441British Heart Foundation FS/19/1/34035British Heart Foundation PG/15/16/31330British Heart Foundation RG/11/18/29257
6 · The paper itself

Abstract

backgroundHeart rate follows a diurnal variation, and slow heart rhythms occur primarily at night.

objectiveThe lower heart rate during sleep is assumed to be neural in origin, but here we tested whether a day-night difference in intrinsic pacemaking is involved.

methodsIn vivo and in vitro electrocardiographic recordings, vagotomy, transgenics, quantitative polymerase chain reaction, Western blotting, immunohistochemistry, patch clamp, reporter bioluminescence recordings, and chromatin immunoprecipitation were used.

resultsThe day-night difference in the average heart rate of mice was independent of fluctuations in average locomotor activity and persisted under pharmacological, surgical, and transgenic interruption of autonomic input to the heart. Spontaneous beating rate of isolated (ie, denervated) sinus node (SN) preparations exhibited a day-night rhythm concomitant with rhythmic messenger RNA expression of ion channels including hyperpolarization-activated cyclic nucleotide-gated potassium channel 4 (HCN4). In vitro studies demonstrated 24-hour rhythms in the human HCN4 promoter and the corresponding funny current. The day-night heart rate difference in mice was abolished by HCN block, both in vivo and in the isolated SN. Rhythmic expression of canonical circadian clock transcription factors, for example, Brain and muscle ARNT-Like 1 (BMAL1) and Cryptochrome (CRY) was identified in the SN and disruption of the local clock (by cardiomyocyte-specific knockout of Bmal1) abolished the day-night difference in Hcn4 and intrinsic heart rate. Chromatin immunoprecipitation revealed specific BMAL1 binding sites on Hcn4, linking the local clock with intrinsic rate control.

conclusionThe circadian variation in heart rate involves SN local clock-dependent Hcn4 rhythmicity. Data reveal a novel regulator of heart rate and mechanistic insight into bradycardia during sleep.

Indexed as

Gene Expression RegulationAnimalsBradycardiaCircadian ClocksDisease Models, AnimalElectrocardiographyHyperpolarization-Activated Cyclic Nucleotide-Gated ChannelsMiceRNASinoatrial NodeHcn4 protein, mouseHyperpolarization-Activated Cyclic Nucleotide-Gated ChannelsRNABradycardiaCircadian rhythmPacemakingSinus nodeVagus nerve

Identifiers

PMID33278629
PMCPMC8073545
OpenAlexW3109123888

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.