心血管疾患と診断

Influence of Meteorological Factors on the Incidence of Acute Type A Aortic Dissections in Northern Europe

Abstract

Simon Junghans1#, Peter Donndorf2*# ,Thore Scherff3, Christoph Lutter4, Anja Pueschel2 and Justus Groß1

Background: Acute Type A Aortic Dissection (TAAD) is a life-threatening disease. Apart from the well- known atherosclerotic risk factor, circadian, seasonal and climate-related patterns are also factors with a significantly higher risk in winter, on the first day of the working week, and in the morning hours (between 6 a.m. and 12 p.m.). Acute TAAD can also be triggered by higher mean arterial blood pressure with corresponding blood pressure peaks, and changes in atmospheric pressure. The aim of this study is to analyze climatic parameters in the catchment area of Kiel in northern Germany which can influence the occurrence of acute TAAD.

Methods: All acute TAAD repairs from January 1^st, 2012 to November 24^th, 2017 in the University of Hospital Schleswig-Holstein Campus (UKSH) were evaluated. Traumatic aortic dissections were excluded. Statistics were performed regarding to R&R commander programs using Wilcoxon rank sum test for data correlation analyzes.

Results: A total of 181 acute TAAD repairs were identified. There were no significant correlation between the mean temperature and the number of acute TAAD incidents, the mean differences between the daily averages of the weather parameters or the mean temperature on the days (0-14) before the onset of acute TAAD. However, precipitation remains constant on the 3^rd and 4^th days before acute dissection and decreases the day before (t=-1). On the day of acute dissection (t=0), it increases significantly.

Conclusion: Relative climatic changes (rather than absolute values) may have a greater effect on the incidence of acute dissection. The effect of climatic variations appear to depend on the local context, such as the initial value at which the variation begins. Lower temperatures (from a higher baseline temperature) have a different effect than lowering it from an already low value. In the Kiel region in northern Europe, the occurrence of acute TAAD is not related to temperature but does increase significantly on days with higher precipitation.