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      Short-term effects of air pollution and weather changes on the occurrence of acute aortic dissection in a cold region

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          Abstract

          Background

          Air pollution and severe weather conditions can adversely affect cardiovascular disease emergencies. Nevertheless, it remains unclear whether air pollutants and low ambient temperature can trigger the occurrence of acute aortic dissection (AAD) in cold regions.

          Methods

          We applied a retrospective analysis to assess the short-term effects of air pollution and ambient temperature on the occurrence of AAD in Harbin, China. A total of 564 AAD patients were enrolled from a major hospital in Harbin between January 1, 2017, and February 5, 2021. Weather condition data and air pollutant concentrations, including fine particulate matter smaller than 10 μm (PM 10) and 2.5 μm in diameter (PM 2.5), nitrogen dioxide (NO 2), sulfur dioxide (SO 2), carbon monoxide (CO), and ozone (O 3), were collected every day. Conditional logistic regressions and correlation analysis were applied to analyze the relationship of environmental and atmospheric parameters with AAD occurrence at lags of 0 to 7 days. Specifically, we appraised the air quality index, CO, NO 2, SO 2, O3, PM 10, PM 2.5, temperature, dew point temperature, atmospheric pressure, and cloud amount.

          Results

          A total of 1,496 days at risk were assessed, of which 564 patients developed AAD. Specifically, AAD did not occur on 1,043 (69.72%) days, while 1 or more cases occurred on 453 (30.28%) days. Several pollution and weather predictors for AAD were confirmed by multilevel modeling. The air quality index ( p = 0.0012), cloud amount ( p = 0.0001), and concentrations of PM 2.5 ( p = 0.0004), PM 10 ( p = 0.0013), NO 2 ( p = 0.0007) and O 3 (p = 0.0001) predicted AAD as early as 7 days before the incident (lag of 7 days) in the study period. However, only concentrations of the air pollutants NO 2 ( p = 0.0468) and O 3 ( p = 0.011) predicted the occurrence of AAD after the COVID-19 outbreak. Similar predictive effects were observed for temperature, dew point temperature, and atmospheric pressure (all p < 0.05) on all days.

          Conclusion

          The risk of AAD is closely related to air pollution and weather characteristics in Harbin. While causation was not determined, the impact of air pollutants on the risk of AAD was reduced after the COVID-19 outbreak.

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          Most cited references40

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          Stephen S Lim, Theo Vos, Abraham D. Flaxman … (2012)
          The Lancet, 380(9859), 2224-2260
          Article 0 comments Cited 3839 times – based on 0 reviews     Review now
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            Management of acute aortic dissection.

            Christoph Nienaber, Rachel Clough (2015)
            A new appraisal of the management of acute aortic dissection is timely because of recent developments in diagnostic strategies (including biomarkers and imaging), endograft design, and surgical treatment, which have led to a better understanding of the epidemiology, risk factors, and molecular nature of aortic dissection. Although open surgery is the main treatment for proximal aortic repair, use of endovascular management is now established for complicated distal dissection and distal arch repair, and has recently been discussed as a pre-emptive measure to avoid late complications by inducing aortic remodelling.
            Article 0 comments Cited 168 times – based on 0 reviews     Review now
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              Acute Aortic Dissection and Intramural Hematoma: A Systematic Review.

              Firas F Mussa, Joshua Horton, Rameen Moridzadeh … (2016)
              Acute aortic syndrome (AAS), a potentially fatal pathologic process within the aortic wall, should be suspected in patients presenting with severe thoracic pain and hypertension. AAS, including aortic dissection (approximately 90% of cases) and intramural hematoma, may be complicated by poor perfusion, aneurysm, or uncontrollable pain and hypertension. AAS is uncommon (approximately 3.5-6.0 per 100,000 patient-years) but rapid diagnosis is imperative as an emergency surgical procedure is frequently necessary.
              Article 0 comments Cited 135 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 02 August 2023
                Publication date Collection: 2023
                Publication date PMC-release: 02 August 2023
                Volume: 11
                Electronic Location Identifier: 1172532
                Affiliations
                [1] 1Department of Cardiology, First Affiliated Hospital of Harbin Medical University , Harbin, Heilongjiang, China
                [2] 2Department of Emergency, The First Affiliated Hospital of Harbin Medical University , Harbin, China
                [3] 3School of Computer Science and Technology, Harbin Institute of Technology , Harbin, China
                [4] 4School of Information and Computer Engineering, Northeast Forestry University , Harbin, Heilongjiang, China
                [5] 5School of Computer Science and Technology, Harbin Institute of Technology , Weihai, Shandong, China
                [6] 6Department of Cardiology, Harbin Second Hospital , Harbin, China
                [7] 7Department of Medical Record, The Second Affiliated Hospital of Harbin Medical University , Harbin, China
                [8] 8Department of Obstetrics and Gynecology, First Affiliated Hospital of Harbin Medical University , Harbin, Heilongjiang, China
                Author notes

                Edited by: Mohammad Javad Mohammadi, Ahvaz Jundishapur University of Medical Sciences, Iran

                Reviewed by: Antonella Bodini, National Research Council (CNR), Italy; Nagisa Morikawa, Kurume University, Japan; Marzieh Sadeghian, Ahvaz Jundishapur University of Medical Sciences, Iran

                *Correspondence: Tao Song, shutiao1981@ 123456sina.com

                †These authors have contributed equally to this work

                Article
                DOI: 10.3389/fpubh.2023.1172532
                PMC ID: 10433911
                SO-VID: 3ebb3611-b59a-4c25-bc09-9311f0969740
                Copyright © Copyright © 2023 Zhang, Yin, Zhang, Qiu, Peng, Wang, Sun, Ding, Liu, Du, Wang, Sun, Chen, Zhao, Song and Sun.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 23 February 2023
                Date accepted : 13 July 2023
                Page count
                Figures: 4, Tables: 4, Equations: 0, References: 40, Pages: 12, Words: 8525
                Funding
                Funded by: Heilongjiang Postdoctoral Research Foundation
                Award ID: LBH-Q20110
                Funded by: Scientific Research Fund of the First Affiliated Hospital of Harbin Medical University
                Award ID: HYD2020YQ0004
                Award ID: 2020M20
                Award ID: 2020M08
                Categories
                Subject: Public Health
                Subject: Original Research
                Custom metadata
                section-at-acceptance Environmental health and Exposome

                Keywords: weather,environment,temperature,pollution,acute aortic dissection,covid-19
                Data availability:
                Keywords: weather, environment, temperature, pollution, acute aortic dissection, covid-19

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