Obstructive sleep apnea in patients with acute aortic dissection.

Area of Science:

• Cardiology
• Sleep Medicine
• Vascular Surgery

Background:

• Obstructive sleep apnea (OSA) increases left ventricle afterload and aortic wall pressure gradients, potentially elevating the risk of aortic dissection (AD).
• Understanding the relationship between OSA and AD is crucial for patient management and risk stratification.

Purpose of the Study:

• To investigate the prevalence of OSA in patients diagnosed with acute aortic dissection.
• To explore potential associations between OSA and demographic, clinical, and aortic characteristics in AD patients.

Main Methods:

• A cohort of 40 patients with acute AD was studied across four institutions.
• 37 patients completed the modified Berlin Questionnaire, and 31 underwent polysomnography to assess OSA.
• Aortic diameters were measured using CT scans at seven predefined locations.

Main Results:

• The prevalence of OSA (Apnea-Hypopnea Index ≥ 5) was 61% among the studied patients.
• No significant difference in nocturnal symptom presentation was observed between patients with and without OSA.
• Patients with OSA exhibited numerically larger aortic diameters across multiple measurement sites compared to those without OSA, although statistical significance was not reached.

Conclusions:

• OSA is highly prevalent in patients with acute aortic dissection.
• While OSA was not associated with nocturnal presentation, it may correlate with larger aortic diameters at the time of dissection.
• The study's small sample size limits definitive conclusions, highlighting the need for larger investigations.