Obstructive Sleep Apnea in Patients with Abdominal Aortic Aneurysms

Mason, Rebecca H.; Ruegg, Gion; Perkins, Jeremy; Hardinge, Maxine; Amann-Vesti, Beatrice; Senn, Oliver; Stradling, John; Kohler, Malcolm

doi:10.1164/rccm.201001-0051oc

Cited by 61 publications

(60 citation statements)

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“…An international multicentre study found that ∼40% of patients aged 18-75 years in an AAA surveillance register presented with an AHI >10 events·h −1 [59]. Cross-sectional data indicated no association of aortic diameter with AHI [59].…”

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confidence: 99%

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confidence: 99%

“…Cross-sectional data indicated no association of aortic diameter with AHI [59]. In order to investigate a possible association between OSA/AHI and rate of AAA expansion, MASON et al [59] assessed patients with AAA during a median follow-up interval of 18 months. From the total cohort (n=127), patients with severe forms of OSA (ODI >30 events·h ) had a significantly faster median yearly AAA expansion rate than patients with ODI <5 events·h −1 ( p<0.05), independent of cardiovascular risk markers [59].…”

Section: −1mentioning

confidence: 99%

“…In order to investigate a possible association between OSA/AHI and rate of AAA expansion, MASON et al [59] assessed patients with AAA during a median follow-up interval of 18 months. From the total cohort (n=127), patients with severe forms of OSA (ODI >30 events·h ) had a significantly faster median yearly AAA expansion rate than patients with ODI <5 events·h −1 ( p<0.05), independent of cardiovascular risk markers [59]. Other studies using indirect measures of OSA (Berlin Questionnaire) reported that about 60% of AAA patients are likely to have OSA [60].…”

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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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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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The impact of obstructive sleep apnoea on the aorta

2015

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“…Khayi et al, suggest that the regulation of ocular blood flow, which partially depends on the sympathetic and parasympathetic systems, is not altered without comorbidities associated with OSAHS (25) . However, it has been shown that there is an increased risk of cardiovascular and pulmonary diseases in OSAHS patients (29) . An increased risk of glaucoma in OSAHS patients may also be associated with additional pathologies that are compatible with the vascular theory of glaucoma.…”

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Evaluation of choroidal thickness in patients with obstructive sleep apnea/hypopnea syndrome

Kara¹,

Özçimen²,

Bekçi³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Obstructive sleep apnea/hypopnea syndrome (OSAHS) is characterized by transient upper airway resistance caused by a recurrent reduction or cessation of airflow, due to partial or complete occlusion of the upper airway during sleep. It is associated with sleep fragmentation, arousals, bradycardia, tachycardia, and inadequate oxygen saturation despite an increased respiratory effort (1) . Major clinical consequences of the disorder include excessive daytime sleepiness, neurocognitive dysfunction, cardiovascular diseases (hypertension, ABSTRACTPurpose: To compare the subfoveal choroidal thickness (SFCT) of patients with different severities of obstructive sleep apnea/hypopnea syndrome (OSAHS) and normal controls via enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this retrospective, case-control study, 49 eyes from 49 patients that had undergone polysomnography were included. SFCT of the horizontal and vertical line scans were manually measured for all eyes based on EDI-OCT images. Two separate analyses were performed according to different apnea/hypopnea index (AHI) groupings. Initial testing was conducted using non-OSAHS, mild OSAHS (5≤AHI<15), moderate OSAHS (15≤AHI<30), and severe OSAHS (AHI≥30) patient groupings, while secondary testing used non-OSAHS, mild OSAHS (5≤AHI<15), and moderate/severe OSAHS (AHI≥15) patient groupings. Results: The mean SFCT was 314.5 µm in the non-OSAHS patients (n=14), 324.5 µm in the mild OSAHS patients (n=15), 269.3 µm in the moderate OSAHS patients (n=11), and 264.3 µm in the severe OSAHS patients (n=9). SFCT between the four groups revealed no significant differences despite a trend towards slight thinning in the severe group (P=0.08). When the moderate and severe groups were merged and compared with the mild OASHS and non-OSAHS groups, SFCT of the moderate/severe group was found to be significantly thinner than that of the mild group (P=0.016). A negative significant correlation was found between SFCT and AHI in OSAHS patients (r=0.368, P=0.033). Conclusions:In patients with moderate/severe OSAHS, EDI-OCT revealed a thinned SFCT. Other accompanying systemic or ocular diseases may induce perfusion and oxygenation deficiency in eyes of OSAHS patients. Further studies are required in order to determine the exact relationships between ocular pathologies and clinical grades of OSAHS. Keywords

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Obstructive sleep apnea as a potential risk factor for aortic disease

et al. 2011

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Obstructive sleep apnea (OSA) is not only a cause of hypertension; it also possibly affects the pathogenesis and progression of aortic disease because an inspiratory effort-induced increase in negative intrathoracic pressure generates mechanical stress on the aortic wall. The objective of the present study was to examine the incidence by location of OSA as a complication in patients with aortic aneurysm and patients with aortic dissection (AD). An overnight sleep study was conducted in the following study groups: the aortic disease group (n = 95) consisting of patients with thoracic aortic aneurysm (TAA, n = 32), patients with abdominal aortic aneurysm (AAA, n = 36), and patients with AD (n = 27); and a control group (n = 32), consisting of patients with coronary risk factors who were matched with the aortic disease group for age, gender, and body mass index (BMI). The 3% oxygen desaturation index (ODI) was significantly higher in all the TAA, AAA, and AD groups (P = 0.045, P = 0.003, and P = 0.005, respectively) than in the control group. The incidence of moderate to severe OSA [apnea hypopnea index (AHI) ≥15 events/h] was significantly higher in the first three groups (P = 0.026, P = 0.001, P = 0.003, respectively) than in the control group, while no significant difference was found between the TAA group and the AAA group with respect to these variables. Furthermore, no significant differences were found between the thoracic AD subgroup and the abdominal AD subgroup with respect to AHI and 3% ODI, as well as with respect to the incidences of moderate to severe OSA. Patients with TAA, patients with AAA, and patients with AD showed high incidences of moderate to severe OSA. Although this result suggests that OSA may be one of risks for aortic disease, unelucidated mechanism(s) other than negative intrathoracic pressure may be involved in the pathogenesis of aortic disease.

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Obstructive Sleep Apnea in Patients with Abdominal Aortic Aneurysms

Abstract: In patients with AAA, OSA is highly prevalent. Severe OSA may be a causal factor for faster AAA expansion, but this needs to be proved in a randomized controlled intervention trial.

Cited by 61 publications

References 32 publications

The impact of obstructive sleep apnoea on the aorta

The impact of obstructive sleep apnoea on the aorta

Evaluation of choroidal thickness in patients with obstructive sleep apnea/hypopnea syndrome

Obstructive sleep apnea as a potential risk factor for aortic disease

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