Obstructive sleep apnoea and the progression of thoracic aortic aneurysm: a prospective cohort study.
Eur Respir J
; 57(5)2021 05.
Article
em En
| MEDLINE
| ID: mdl-33214207
ABSTRACT
BACKGROUND:
Obstructive sleep apnoea (OSA) is associated with an increased prevalence of aortic aneurysms and it has also been suggested that severe OSA furthers aneurysm expansion in the abdomen. We evaluated whether OSA is a risk factor for the progression of ascending thoracic aortic aneurysm (TAA).METHODS:
Patients with TAA underwent yearly standardised echocardiographic measurements of the ascending aorta over 3â years and two level III sleep studies. The primary outcome was the expansion rate of TAA in relation to the apnoea-hypopnoea index (AHI). Secondary outcomes included surveillance for aortic events (composite end-points of rupture/dissection, elective surgery or death).RESULTS:
Between July 2014 and March 2020, 230 patients (median age 70â years, 83.5% male) participated in the cohort. At baseline, 34.8% of patients had AHI ≥15â events·h-1. There was no association between TAA diameter and AHI at baseline. After 3â years, mean±sd expansion rates were 0.55±1.25â mm at the aortic sinus and 0.60±1.12â mm at the ascending aorta. In the regression analysis, after controlling for baseline diameter and cardiovascular risk factors, there was strong evidence for a positive association of TAA expansion with AHI (aortic sinus estimate 0.025â mm, 95% CI 0.009-0.040â mm; p<0.001 and ascending aorta estimate 0.026â mm, 95% CI 0.011-0.041â mm; p=0.001). 20 participants (8%) experienced an aortic event; however, there was no association with OSA severity.CONCLUSION:
OSA may be a modest but independent risk factor for faster TAA expansion and thus potentially contributes to life-threatening complications in aortic disease.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Aneurisma da Aorta Torácica
/
Apneia Obstrutiva do Sono
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Suíça