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Published on: March 28, 2025
Circadian variations in the onset of aortic dissection in northern China
Liang Zhang1, Juntao Qiu1, Xiubin Yang1
1a Department of cardiac surgery , Beijing Anzhen Hospital, Capital Medical University, Beijing, Institute of Heart, Lung and Blood vessel Disease , Beijing , China.
Insights
Aortic dissection shows daily and seasonal patterns in northern China, peaking in the afternoon (13:00-18:00) and during winter. These findings aid in predicting and preventing aortic dissection onset.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Acute aortic dissection is a life-threatening condition.
- Understanding its temporal patterns can improve clinical outcomes and prevention strategies.
Purpose of the Study:
- To investigate the circadian and seasonal variations in the onset of acute aortic dissection.
- To identify peak periods for aortic dissection to enhance predictability and prevention.
Main Methods:
- Retrospective analysis of 1121 patients with acute aortic dissection from January 2010 to December 2016.
- Analysis of daily, monthly, and seasonal onset patterns, including weekday/weekend and diurnal variations.
- Comparison of demographic and clinical factors across different time periods and seasons.
Main Results:
- The peak onset period for aortic dissection was between 13:00 and 18:00 daily.
- Winter showed the highest incidence (30.9%), while summer had the lowest (16.6%).
- No significant differences in onset patterns were found between weekdays and weekends, or between males and females.
Conclusions:
- Acute aortic dissection exhibits significant circadian and seasonal patterns in northern China.
- The afternoon (13:00-18:00) and winter are identified as peak times for dissection onset.
- These temporal patterns are consistent across different sexes, ages, and dissection types, offering targets for preventative measures.
Abstract:
This study explored the periodic changes in the onset of aortic dissection in a single center in northern China, with the goal to improve predictability and prevention. We collected the clinical data of 1121 patients from Hebei Province treated for acute aortic dissection at Fuwai Hospital between January 2010 and December 2016. The patterns of aortic dissection during different periods of each day, each month, and each quarter of a year were analyzed. Variations in the number of cases were summarized for weekdays, weekends, and different periods of a day in each season. We compared the differences in gender, age, body mass index, Marfan syndrome, hypertension, and the type of aortic dissection during different time periods and different seasons. In the study, 774 patients (69.1%) with type A aortic dissection and 347 patients (30.9%) with type B aortic dissection were included. The average age of 1121 patients was 51.4 ± 12.0 years. Overall, the peak period for the onset of aortic dissection in a day was between 13:00 and 18:00. There was no statistically significant difference in the number of cases between weekdays and weekend (P = 0.94). Most cases occurred in winter (30.9%); the rate of onset was the lowest in summer (16.6%). No statistically significant difference was observed between male and female patients in terms of variations during different periods of a day (P = 0.45) and seasons (P = 0.12). In conclusion, aortic dissection displayed circadian and seasonal patterns in northern China. Onset of the disease peaked between 13:00 and 18:00 in a day. Winter was the peak season for the onset of acute aortic dissection, regardless of sex, type of dissection and age.
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