Once after a full moon: acute type A aortic dissection and lunar phases.

Autor:	Bjursten H; Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden., Oudin Åström D; Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.; Division of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Nozohoor S; Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden., Ahmad K; Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark., Tang M; Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark., Bjurbom M; Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden., Hansson EC; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden., Jeppsson A; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden., Joost Holdflod Møller C; Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark., Jormalainen M; Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland., Juvonen T; Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.; Research Unit of Surgery, Anesthesia, and Critical Care, University of Oulu, Oulu, Finland., Mennander A; Heart Centre, Tampere University Hospital and University of Tampere, Tampere, Finland., Olsen PS; Department of Cardiothoracic Surgery, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, Copenhagen, Denmark., Olsson C; Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden., Ahlsson A; Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden., Oudin A; Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.; Division of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Pan E; Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.; Turku University Hospital, Turku, Finland., Raivio P; Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland., Wickbom A; Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital and Faculty of Medicine and Health, Orebro University, Orebro, Sweden., Sjögren J; Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden., Geirsson A; Section of Cardiac Surgery, Yale University School of Medicine, New Haven, CT, USA.; Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland., Gudbjartsson T; Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland., Zindovic I; Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden.
Jazyk:	angličtina
Zdroj:	Interactive cardiovascular and thoracic surgery [Interact Cardiovasc Thorac Surg] 2022 Jan 06; Vol. 34 (1), pp. 105-110. Date of Electronic Publication: 2021 Aug 27.
DOI:	10.1093/icvts/ivab220
Abstrakt:	Objectives: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD. Methods: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period). Results: The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated. Conclusions: This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable. (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
Databáze:	MEDLINE
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