title: Linkage of sleep-disordered breathing and acute aortic dissection with patent false lumen.
abstract: Sleep-disordered breathing (SDB) is known as a cardiovascular risk factor and has high prevalence in hypertension, which is a major risk factor of aortic dissection (AD). However, the impact of SDB on AD has not been fully clarified. The aim of this study is to elucidate the impact of SDB on AD, especially on the type of false lumen in AD. We enrolled twenty-three consecutive patients with acute AD (mean age: 66 ± 13 years). All subjects were evaluated by an ambulatory polygraphic sleep monitoring within 1 month from the onset. AD was evaluated by axial images of computed tomography. We comparatively analyzed SDB and AD. 35 % of the subjects presented severe OSA (apnea-hypopnea index: AHI ≥30). The patent false lumen group showed significantly higher systolic and diastolic blood pressure (BP) on arrival and AHI, and lower percutaneous oxygen saturation (SaO2) compared with those in the thrombosed false lumen group. The prevalence of severe SDB was higher in the patent false lumen group (60 vs 15 %, p = 0.039). Systolic BP on arrival was significantly correlated with AHI (r = 0.457, p = 0.033) and the minimum SaO2 (r = -0.537, p = 0.010). The present study revealed close linkage between SDB and AD, and a high prevalence of SDB among AD patients. Severe SDB was related to the development of AD, especially for the patent false lumen type through highly elevated BP which might be easily evoked in the presence of severe SDB. Repetitive occurrence of intrathoracic negative pressure also might influence the repair or closure of false lumen of AD, although the present analysis did not reach statistical significance.
authors.affiliation: Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan. t-inami@nms.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Inami
authors.affiliation: Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Seino
authors.affiliation: Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shimura
authors.affiliation: Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kurihara
authors.affiliation: Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan.
authors.forename: Nakahisa
authors.initials: N
authors.lastname: Kimata
authors.affiliation: Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Murakami
authors.affiliation: Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Munakata
authors.affiliation: Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takano
authors.affiliation: Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohba
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D001027:Aortography / Q000379:methods; D001794:Blood Pressure; D000072226:Computed Tomography Angiography; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*
keywords: Aortic dissection; Nocturnal hypoxia; Patent false lumen; Sleep apnea; Sleep-disordered breathing