Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden.
Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
Interact Cardiovasc Thorac Surg. 2022 Jan 6;34(1):105-110. doi: 10.1093/icvts/ivab220. Epub 2021 Aug 27.
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.
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).
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.
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.
急性 A 型主动脉夹层（ATAAD）是一种罕见但严重的疾病，通常采用紧急心脏手术进行治疗。许多外科医生认为 ATAAD 患者倾向于成群出现，但尚无研究对此进行观察。本研究旨在探讨月球周期与 ATAAD 发病之间的潜在关联。
我们收集了北欧急性 A 型主动脉夹层协作组中心进行的 2995 例 ATAAD 手术患者的信息。我们使用病例交叉设计，使用两种不同的满月定义（>99%照明和 7 天满月期），将手术时间与月相进行交叉参考。
月亮照明最多的时期（99%定义）并未显示 ATAAD 手术发病率的显著增加。然而，与所有其他月相相比，满月期的相对风险为 1.08（95%置信区间 1.00-1.17，P=0.057），与凸月相比，仅相对风险为 1.11（95%置信区间 1.01-1.23，P=0.027）。发病高峰出现在月亮完全照明后 4-6 天。
本研究发现 ATAAD 手术在满月期间的代表性过高。其原因尚不清楚，但我们推测，满月期间的睡眠不足会导致血压暂时升高，从而可能导致主动脉壁破裂。虽然这一发现很有趣，但需要进一步证实，其临床意义仍存在争议。
