title: Obstructive sleep apnea as a potential risk factor for aortic disease.
abstract: 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.
authors: Second Department of Internal Medicine (Cardiology), Tokyo Medical University, Tokyo, Japan.
authors: Hirokazu
authors: H
authors: Saruhara
authors: Yoshifumi
authors: Y
authors: Takata
authors: Yasuhiro
authors: Y
authors: Usui
authors: Kazuki
authors: K
authors: Shiina
authors: Yuki
authors: Y
authors: Hashimura
authors: Kota
authors: K
authors: Kato
authors: Kihiro
authors: K
authors: Asano
authors: Satoshi
authors: S
authors: Kawaguchi
authors: Yukio
authors: Y
authors: Obitsu
authors: Hiroshi
authors: H
authors: Shigematsu
authors: Akira
authors: A
authors: Yamashina
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001027:Aortography / Q000379:methods; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed