Chronologic and Climatic Factors of Acute Aortic Dissection: Study of 1642 Patients in Two Continents

Ma, Wei-Guo; Li, Bin; Zhang, Wei; Sarkar, Abdullah E.H.; Tufail, Rabeya; Peterß, Sven; Zheng, Jun; Zafar, Mohammad A.; Ziganshin, Bulat A.; Zhu, Jun; Sun, Lu; Elefteriades, John A.

doi:10.1016/j.athoracsur.2019.11.013

Cited by 18 publications

(21 citation statements)

References 40 publications

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“…During the colder periods, cold exposure can trigger several physiological responses, such as vasoconstriction, elevated blood pressure, platelet activation, or increased levels of inflammatory blood biomarkers. These acute and chronic physiological responses have potentially adverse cardiovascular effects (24)(25)(26). In fact, an increased systolic blood pressure (SBP) associated with low outdoor temperature was reported previously, with 6 mmHg higher SBP per 10 • C lower outdoor temperature (27).…”

Section: Discussionmentioning

confidence: 93%

“…AAD was described as a high incidence during the cold period, with a peak in January (22), suggesting a potential connection between climate characteristics and the onset of AAD. The incidence of AAD was correlated to the average temperature and atmospheric pressure, as a study of 1,642 patients in two continents reported (24). Climatic changes, such as temperature, humidity, and atmospheric pressure, have the potential to provoke physiological changes on humans.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence, Clinical Features, and In-hospital Outcome of Fatty Liver Disease in Acute Aortic Dissection: A Single-Center Retrospective Study

Zuo

Cai

Wang

et al. 2021

Front. Cardiovasc. Med.

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Background and Aims: Fatty liver disease (FLD) has emerged as a major public issue in China. We aim to investigate prevalence, clinical features, and in-hospital outcome of FLD in acute aortic dissection (AAD) patients.Methods: Data of 379 AAD patients from 2017 to 2019 at Renmin hospital of Wuhan University was retrospectively collected and divided according to age and FLD absence. Propensity score matching was used for minimal confounding. We compared their physical environmental parameter of onset, clinical features, and in-hospital outcome.Results: The mean age was 52.0 ± 11.5 years in type A and 55.1 ± 11.4 in type B. 25.0% of type A and 19.2% of type B AAD patients had FLD. Logistic regression indicated a negative association between FLD and age, both in type A [unadjusted odds ratio (OR) 0.958 (per 1 year), 95% confidence interval (CI) 0.930–0.988, p = 0.0064] and type B [unadjusted OR 0.943 (per 1 year), 95% CI 0.910–0.978, p = 0.0013]. After matching, type A with FLD had onset with a lower air quality index (AQI) of 68.5 [interquartile range (IQR) 46.0–90.0] and a lower Pm 2.5 concentration of 36.0 μg/m3 (IQR 23.0–56.0) compared with non-FLD group. In Kaplan-Meier estimation, FLD was associated with higher risk of in-hospital mortality in type B AAD (p = 0.0297).Conclusion: The prevalence of FLD in AAD decrease with age, both in type A and type B AAD. Type A AAD patients with FLD had onset with better air quality parameters compared with non-FLD group. FLD was associated with higher risk of in-hospital mortality in type B AAD.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Prevalence, Clinical Features, and In-hospital Outcome of Fatty Liver Disease in Acute Aortic Dissection: A Single-Center Retrospective Study

Zuo

Cai

Wang

et al. 2021

Front. Cardiovasc. Med.

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“… 4 8 Moreover, the concentrations of air pollutants, especially fine particulate matter, are also elevated in winter and are associated with aortic plaque progression, hypertension and aortic constriction. 9 These changes may lead to a surge in the shear forces exerted on the aortic intima, triggering AAD in colder months. 8 …”

Section: Discussionmentioning

confidence: 99%

“…Some studies reported a Monday peak, 12 14 16 while others reported a Wednesday peak. 9 The weekly distribution of cardiovascular disease (CVD) may reflect physiological fluctuations resulting from an increase in physical and mental burdens from leisurely weekend activities to stressful weekdays. 17 Different working statuses and occasional holidays may easily alter the weekly patterns of AAD onset, leading to a non-significant result.…”

Section: Discussionmentioning

confidence: 99%

“…However, limited studies have discussed how the time of day, week and year affect the onset of AAD, and most of these studies were conducted in Western countries with limited sample sizes and without subgroup analyses. [8][9][10][11][12][13] To evaluate the effect of chronobiological patterns on the occurrence of AAD, we aimed to expound the temporal trends of AAD onset in an 8-year timeseries study in central China, and we believe that these data could help predict and prevent the disastrous outcomes of this condition.…”

Section: Introductionmentioning

confidence: 99%

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Chronobiological patterns of acute aortic dissection in central China

Xia

Huang

Xiao

et al. 2020

Heart

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BackgroundAcute aortic dissection (AAD) is a life-threatening emergency with poor clinical outcomes. Understanding the chronological patterns of AAD onset would be helpful for identifying the triggers of AAD and preventing this catastrophic event.MethodsWe collected data from 2048 patients diagnosed with AAD at Tongji Hospital (Wuhan, China) from 2011 to 2018. The χ2 test was used to determine whether a specific period had significantly different seasonal/weekly distributions from other periods. Fourier models were used to analyse the rhythmicity in monthly/circadian distribution.ResultsThe mean age was 53.4±10.9 years, and 1161 patients (56.7%) were under 55 years. One thousand six hundred fifty-seven patients (80.9%) were male, and 935 cases (45.7%) were type A dissections. The proportions of patients with comorbid hypertension/diabetes were 60.3% (1234 cases) and 1.8% (36 cases), respectively. A peak was identified in colder periods (winter/December) and a trough in warmer periods (summer/June). No significant variation was observed in weekly distribution. Fourier analysis showed a statistically significant circadian variation (p<0.001) with a nocturnal trough in 2:00–3:00, a morning peak in 9:00–10:00, and an afternoon peak in 16:00–17:00. Subgroup analyses identified circadian rhythmicity in all subgroups except for the female group and younger group (younger than 55 years).ConclusionOur results confirmed that the onset of AAD exhibits significant seasonal, monthly and circadian patterns. Patients with AAD with different Stanford-type dissections, sexes, ages and hypertension statuses could present different circadian variations. These findings may provide novel perspectives for identifying the triggers of AAD and better preventing this catastrophic event.

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Safety and efficacy of alcohol septal ablation in adolescents and young adults with hypertrophic obstructive cardiomyopathy

et al. 2021

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Chronologic and Climatic Factors of Acute Aortic Dissection: Study of 1642 Patients in Two Continents

Cited by 18 publications

References 40 publications

Prevalence, Clinical Features, and In-hospital Outcome of Fatty Liver Disease in Acute Aortic Dissection: A Single-Center Retrospective Study

Prevalence, Clinical Features, and In-hospital Outcome of Fatty Liver Disease in Acute Aortic Dissection: A Single-Center Retrospective Study

Chronobiological patterns of acute aortic dissection in central China

Safety and efficacy of alcohol septal ablation in adolescents and young adults with hypertrophic obstructive cardiomyopathy

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