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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

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Aortic diseases and obstructive sleep apnea.

Hisato Takagi1, Takuya Umemoto

  • 1Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan - kfgth973@ybb.ne.jp.

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Obstructive sleep apnea (OSA) is common in patients with aortic diseases and may increase their risk. Further research is needed to confirm if OSA causes aortic diseases and if CPAP therapy can reduce this risk.

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Area of Science:

  • Cardiology
  • Sleep Medicine
  • Vascular Surgery

Background:

  • Obstructive sleep apnea (OSA), especially moderate-to-severe cases, is linked to increased mortality and cardiovascular events.
  • Continuous positive airway pressure (CPAP) therapy can mitigate these risks.
  • A high prevalence of undiagnosed, severe OSA has been observed in patients with thoracic aortic dissection (AD) since 2003.

Purpose of the Study:

  • To review existing clinical studies on the association between aortic diseases and OSA.
  • To synthesize current evidence regarding the link between OSA and various aortic conditions.

Main Methods:

  • Systematic literature search conducted up to May 2015.
  • Review of clinical studies investigating the relationship between aortic diseases (aneurysms and dissection) and OSA.

Main Results:

  • OSA appears highly prevalent in patients with aortic diseases and is associated with aortic expansion.
  • Nocturnal OSA-related factors like hypoxia and sympathetic activation may increase vascular risks (oxidative stress, inflammation, endothelial dysfunction).
  • The causal relationship between OSA and aortic diseases remains unclear: common etiology or OSA as a cause.

Conclusions:

  • Long-term prospective cohort studies are needed to compare aortic disease incidence in OSA versus non-OSA subjects.
  • Randomized controlled trials are required to determine if CPAP therapy for OSA can reduce aortic disease incidence.