Prognostic Significance of Sleep Apnea Syndrome on False Lumen Aortic Expansion in Post-Acute Aortic Syndrome.
BACKGROUND
Obstructive sleep apnea syndrome (OSAS) is a risk factor for resistant arterial hypertension and aortic dilatation. We assessed the value of systematic screening for OSAS in patients soon after the onset of acute aortic syndrome (AAS).


METHODS
Between January 2010 and June 2014, patients were prospectively screened for post AAS OSAS. The severity of OSAS was defined by the Apnea-Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI). Blood pressure control was assessed with 24-h ambulatory monitoring.


RESULTS
The study population comprised 71 patients (males: 64.7%; median age [interquartile range]: 57 [49 to 64] years; type A AAS: 49.3%; type B AAS: 50.7%). According to the AHI, 58 patients (81.7%) had OSAS and 31 (43.6%) had severe OSAS. A prognostic analysis revealed that the descending thoracic false lumen dilatation rate rose significantly with the severity of OSAS (p = 0.0008 for the AHI and p = 0.0284 for the ODI). The median rate of increase was 7.5 (5 to 10) mm/year in the AHI greater than 30 events/h group and 5.0 (0 to 8) mm/year in the ODI greater than 30 events/h group. With regard to blood pressure control, the diastolic blood pressure varied as function of the ODI category (p = 0.0074).


CONCLUSIONS
Our results suggest that systematic screening for post-ASS OSAS is of value. The false lumen dilatation rate appears to be related to the severity of OSAS. It remains to be seen whether treatment of OSAS would modify the false lumen dilatation rate.
Hopital Cardiologique, CHU Lille, Lille, France. Electronic address: pascal.delsart@chru-lille.fr.
Pascal
P
Delsart
Hopital Cardiologique, CHU Lille, Lille, France; CHU Lille, University of Lille, Lille, France.
Francis
F
Juthier
Hopital Cardiologique, CHU Lille, Lille, France; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, England.
Rachel E
RE
Clough
Hopital Cardiologique, CHU Lille, Lille, France; CHU Lille, University of Lille, Lille, France.
Jonathan
J
Sobocinski
Hopital Cardiologique, CHU Lille, Lille, France.
Richard
R
Azzaoui
Hopital Cardiologique, CHU Lille, Lille, France.
Julien
J
Ramstein
EA 2694 - Santé publique : épidémiologie et qualité des soins, CHU Lille, University of Lille, Lille, France.
Patrick
P
Devos
Hopital Cardiologique, CHU Lille, Lille, France.
Natacha
N
Rousse
Hopital Cardiologique, CHU Lille, Lille, France.
Bruno
B
Jegou
Hopital Cardiologique, CHU Lille, Lille, France.
Georges
G
Fayad
Hopital Cardiologique, CHU Lille, Lille, France.
Thomas
T
Modine
Service De Pneumologie, CHU Lille, Lille, France.
Anne
A
Mallart
Hopital Cardiologique, CHU Lille, Lille, France; CHU Lille, University of Lille, Lille, France.
Andre
A
Vincentelli
Hopital Cardiologique, CHU Lille, Lille, France; CHU Lille, University of Lille, Lille, France.
Claire
C
Mounier-Vehier
Hopital Cardiologique, CHU Lille, Lille, France; CHU Lille, University of Lille, Lille, France.
Stephan
S
Haulon
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D001013:Aorta, Thoracic / Q000473:pathology*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D000072226:Computed Tomography Angiography; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D015995:Prevalence; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D015607:Stents; D013577:Syndrome
D010100:Oxygen