Is the aortic root dilated in obstructive sleep apnoea syndrome?

Meuleman, Catherine; Boccara, Franck; Nguyên, Xuân-Lan; Angelantonio, Emanuele Di; Éderhy, Stéphane; Janower, Sandra; Dufaitre, Ghislaine; Haddour, Nabila; Boyer-Chatenet, Louise; Rakotonanahary, Dominique; Fleury, Bernard

doi:10.1016/j.acvd.2008.06.007

Cited by 18 publications

(21 citation statements)

References 37 publications

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“…TANRIVERDI et al [44] reported no difference in aortic diameters (systolic/diastolic) in a matched OSA case-control study. This finding is in agreement with another retrospective study that assessed aortic diameter in 76 OSA patients and found age and sex to be the only determinants for aortic root dilation [46]. However, 84% of these patients were treated with CPAP, which is likely to dilute the association between AHI and aortic diameter [46].…”

Section: General Populationsupporting

confidence: 81%

“…This finding is in agreement with another retrospective study that assessed aortic diameter in 76 OSA patients and found age and sex to be the only determinants for aortic root dilation [46]. However, 84% of these patients were treated with CPAP, which is likely to dilute the association between AHI and aortic diameter [46]. Another study investigated patients with acute myocardial infarction for an association between OSA and aortic diameter [47].…”

Section: General Populationsupporting

confidence: 78%

“…By contrast, two prospective [44,47] and one retrospective study [46] did not establish the aforementioned relationship. TANRIVERDI et al [44] reported no difference in aortic diameters (systolic/diastolic) in a matched OSA case-control study.…”

Section: General Populationmentioning

confidence: 83%

“…These variations include, for example, the facts that the treatment status of OSA was not taken into account [46], common diagnostic criteria have not been consistently applied [45,47,51] and some studies lacked a control group [46,58,60]. In studies assessing the thoracic aorta there is also a high between-study variation in methodological aspects, as studies do not use consistent anatomic landmarks [41,[44][45][46][47][49][50][51]. When considering conflicting results among thoracic and abdominal diameters measured at different anatomic landmarks and the fact that, even in a single study, aortic diameters at different landmarks were distinctly affected by OSA, one may hypothesise that the aetiological significance of OSA may vary along the aorta [53].…”

Section: Current Limitations Of Published Studiesmentioning

confidence: 99%

“…Most of the studies investigated the association between OSA and the aortic root diameter [44][45][46][47][48][49][50][51][52]. Six cross-sectional studies investigating patients referred for a sleep evaluation reported a positive association between the aortic root diameter and parameters of OSA severity (either AHI or oxygen desaturation index (ODI)) [45,[48][49][50][51][52].…”

Section: General Populationmentioning

confidence: 99%

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The impact of obstructive sleep apnoea on the aorta

2015

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Obstructive sleep apnoea (OSA) has been shown to be a causal factor in the pathogenesis of vascular dysfunction and hypertension, conditions which can promote dilation and subsequent aortic dissection and rupture. The objective of this review is to summarise the current literature on the possible association between OSA and aortic disease and delineate the underlying mechanisms.Relevant studies were found by searching for terms including "obstructive sleep apnoea" in combination with "aortic aneurysm, dissection, and dilation" in the MEDLINE and EMBASE databases.Observational studies consistently reported that OSA is highly prevalent among patients with aortic aneurysms and aortic dissections. Patients with co-occurring OSA and Marfan's syndrome as well as patients at the more severe end of the spectrum of OSA seem to be especially vulnerable to aortic disease.Several mechanisms are discussed concerning the link between OSA and aortic disease: nocturnal negative intrathoracic pressure surges leading to mechanical stretching of the aorta and ultimately aortic distension; arousal-induced reflex sympathetic activation with subsequent hypertension; and intermittent hypoxia associated with autonomic nervous system activation and consequently increased oxidative stress. Further well controlled studies are needed in order to define the exact role of OSA as a risk factor for aortic disease. @ERSpublications Several studies have shown an association between obstructive sleep apnoea and aortic aneurysms/dissections http://ow.ly/Nh9jc

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Section: General Populationsupporting

confidence: 81%

Section: General Populationsupporting

confidence: 78%

Section: General Populationmentioning

confidence: 83%

Section: Current Limitations Of Published Studiesmentioning

confidence: 99%

Section: General Populationmentioning

confidence: 99%

See 3 more Smart Citations

The impact of obstructive sleep apnoea on the aorta

2015

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Sleep apnea and the impact on cardiovascular risk in patients with Marfan syndrome

Muiño-Mosquera

Bauters

Dhondt

et al. 2019

Molec Gen & Gen Med

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Background Marfan syndrome (MFS) is an inherited connective tissue disorder characterized by ectopia lentis, aortic root dilation and dissection and specific skeletal features. Obstructive sleep apnea (OSA) in MFS has been described earlier but the prevalence and its relation with the cardiovascular risk is still controversial. This study aimed to further investigate these aspects. Methods In this prospective longitudinal study, we performed an attended polysomnography in 40 MFS patients (60% women, 37 ± 12.8 years) and evaluated several cardiovascular parameters through echocardiography, resting electrocardiogram, 24 hr‐Holter monitoring and serum NT‐ProBNP measurements. Results We found that OSA was present in 42.5% of the patients and that higher body mass index was the most important factor associated with the presence of OSA. We observed that overweight was present in 27.5% of the patients in the whole cohort and in 55.6% if >40 years. Furthermore, when evaluating the impact of OSA on the cardiovascular system, we observed that patients with OSA tended to have higher systolic blood pressure, larger distal aortic diameters and a higher prevalence of ventricular arrhythmia. These differences were, however, not significant after adjusting for confounders. Conclusions Our study shows a high prevalence of OSA and a high prevalence of overweight in MFS patients. We found some trends between OSA and cardiovascular features but we could not establish a solid association. Our study, however might be underpowered, and a multicenter collaborative study could be very useful to answer some important open questions.

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