Prognostic Significance of Sleep Apnea Syndrome on False Lumen Aortic Expansion in Post-Acute Aortic Syndrome

详细信息    查看全文

• 作者：Pascal Delsart ; MD^a ; ^{pascal.delsart@chru-lille.fr" class="auth_mail" title="E-mail the corresponding author} ; Francis Juthier ; MD ; PhD^a ; ^b ; Rachel E. Clough ; MD^a ; ^c ; Jonathan Sobocinski ; MD ; PhD^a ; ^b ; Richard Azzaoui ; MD^a ; Julien Ramstein ; MD^a ; Patrick Devos^d ; Natacha Rousse ; MD^a ; Bruno Jegou ; MD^a ; Georges Fayad ; MD^a ; Thomas Modine ; MD ; PhD^a ; Anne Mallart ; MD^e ; Andre Vincentelli ; MD ; PhD^a ; ^b ; Claire Mounier-Vehier ; MD ; PhD^a ; ^b ; Stephan Haulon ; MD ; PhD^a ; ^b
• 刊名：The Annals of Thoracic Surgery
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：102
• 期：5
• 页码：1558-1564
• 全文大小：412 K

文摘

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.