title: Aortic dissection is associated with intermittent hypoxia and re-oxygenation.
abstract: Aortic dissection is a life-threatening cardiovascular disease with high in-hospital mortality. However, the risk factors of aortic dissection have not been fully elucidated. Obstructive sleep apnea (OSA) has been increasingly recognized as an independent cardiovascular risk factor. Among the underlying mechanisms to explain the association between OSA and cardiovascular morbidity, previous studies reported that intermittent hypoxia and re-oxygenation (IHR) might induce cardiovascular diseases via atherosclerosis. However, little is known about an association between aortic dissection and IHR. The aims of the study were to investigate the prevalence of nocturnal IHR among patients with aortic dissection and compared with that in subjects without aortic dissection, and to investigate whether there is an independent association between aortic dissection and IHR. We enrolled 29 patients with aortic dissection and 59 control subjects. We performed sleep studies and compared the results between the groups. Frequency of IHR is expressed as 3% oxygen desaturation index (ODI). Multivariate analysis was performed to identify determinants of aortic dissection. The percentage of either moderate-to-severe IHR or severe IHR was significantly higher in the aortic dissection group (p = 0.04 and <0.001, respectively) than in the control group. The mean 3% ODI of patients with aortic dissection was significantly higher than that of control subjects (34.8 ± 23.1 and 19.0 ± 14.1, p = 0.003). In multivariate analysis, 3% ODI was significantly associated with aortic dissection (odds ratio 1.44; 95% confidence interval 1.08-1.91; p = 0.01). The present study showed the close association between aortic dissection and, IHR, a major component of OSA.
authors.affiliation: Department of Integrated Medicine I, Saitama Medical Center, Jichi Medical University School of Medicine, 847-1 Amanuma-cho, Oomiya-ku, Saitama, Saitama, 330-8503, Japan. riorio99252@jichi.ac.jp
authors.forename: Ryo
authors.initials: R
authors.lastname: Naito
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakakura
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kubo
authors.forename: Suguru
authors.initials: S
authors.lastname: Yamashita
authors.forename: Koji
authors.initials: K
authors.lastname: Narui
authors.forename: Sugao
authors.initials: S
authors.lastname: Ishiwata
authors.forename: Minoru
authors.initials: M
authors.lastname: Ohno
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Momomura
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000453:epidemiology*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*