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Am J Cardiol. 2017 Mar 1;119(5):785-789. doi: 10.1016/j.amjcard.2016.11.021. Epub 2016 Dec 2.

Chronobiology of Acute Aortic Dissection in the Marfan Syndrome (from the National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions and the International Registry of Acute Aortic Dissection).

Author information

1
Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: hasansiddiqi@gmail.com.
2
Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
3
Department of Cardiology, University of Michigan, Ann Arbor, Michigan.
4
Cardiology Division, University Hospital, Scuola Medica Salernitana, Salerno, Italy.
5
Departments of Pediatrics, Medicine, and Molecular Biology and Genetics, Johns Hopkins University, Baltimore, Maryland.
6
Cardiac Imaging Department, Hospital Universitario Vall d'Hebrón, Barcelona, Spain.
7
Department of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
8
Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Texas.
9
Department of Internal Medicine, University of Ferrara, Ferrara, Italy.
10
Department of Internal Medicine, University of Texas, Houston, Texas.
11
Division of Cardiology and Vascular Medicine, University of Rostock, Rostock, Germany.
12
Division of Cardiology, Cornell University, New York, New York.
13
Department of Cardiology, Robert-Bosch Hospital, Stuttgart, Germany.
14
Department of Pediatric Cardiology, Oregon Health and Science University, Portland, Oregon.

Abstract

Marfan syndrome (MFS) is an autosomal dominant connective tissue disease associated with acute aortic dissection (AAD). We used 2 large registries that include patients with MFS to investigate possible trends in the chronobiology of AAD in MFS. We queried the International Registry of Acute Aortic Dissection (IRAD) and the Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) registry to extract data on all patients with MFS who had suffered an AAD. The group included 257 patients with MFS who suffered an AAD from 1980 to 2012. The chi-square tests were used for statistical testing. Mean subject age at time of AAD was 38 years, and 61% of subjects were men. AAD was more likely in the winter/spring season (November to April) than the other half of the year (57% vs 43%, p = 0.05). Dissections were significantly more likely to occur during the daytime hours, with 65% of dissections occurring from 6 a.m. to 6 p.m. (p = 0.001). Men were more likely to dissect during the daytime hours (6 a.m. to 6 p.m.) than women (74% vs 51%, p = 0.01). These insights offer a glimpse of the times of greatest vulnerability for patients with MFS who suffer from this catastrophic event. In conclusion, the chronobiology of AAD in MFS reflects that of AAD in the general population.

PMID:
28065489
DOI:
10.1016/j.amjcard.2016.11.021
[Indexed for MEDLINE]

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