title: 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).
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.
authors.affiliation: Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: hasansiddiqi@gmail.com.
authors.forename: Hasan K
authors.initials: HK
authors.lastname: Siddiqi
authors.affiliation: Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Luminais
authors.affiliation: Department of Cardiology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Dan
authors.initials: D
authors.lastname: Montgomery
authors.affiliation: Cardiology Division, University Hospital, Scuola Medica Salernitana, Salerno, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
authors.affiliation: Departments of Pediatrics, Medicine, and Molecular Biology and Genetics, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Harry
authors.initials: H
authors.lastname: Dietz
authors.affiliation: Cardiac Imaging Department, Hospital Universitario Vall d'Hebrón, Barcelona, Spain.
authors.forename: Arturo
authors.initials: A
authors.lastname: Evangelista
authors.affiliation: Department of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Eric
authors.initials: E
authors.lastname: Isselbacher
authors.affiliation: Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Scott
authors.initials: S
authors.lastname: LeMaire
authors.affiliation: Department of Internal Medicine, University of Ferrara, Ferrara, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredini
authors.affiliation: Department of Internal Medicine, University of Texas, Houston, Texas.
authors.forename: Dianna
authors.initials: D
authors.lastname: Milewicz
authors.affiliation: Division of Cardiology and Vascular Medicine, University of Rostock, Rostock, Germany.
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Nienaber
authors.affiliation: Division of Cardiology, Cornell University, New York, New York.
authors.forename: Mary
authors.initials: M
authors.lastname: Roman
authors.affiliation: Department of Cardiology, Robert-Bosch Hospital, Stuttgart, Germany.
authors.forename: Udo
authors.initials: U
authors.lastname: Sechtem
authors.affiliation: Department of Pediatric Cardiology, Oregon Health and Science University, Portland, Oregon.
authors.forename: Michael
authors.initials: M
authors.lastname: Silberbach
authors.affiliation: Department of Cardiology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kim A
authors.initials: KA
authors.lastname: Eagle
authors.affiliation: Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Reed E
authors.initials: RE
authors.lastname: Pyeritz
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000209:etiology / Q000503:physiopathology*; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology / Q000503:physiopathology*; D002909:Chronobiology Phenomena; D005260:Female; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012621:Seasons