Abstract
Obstructive sleep apnea (OSA) is a well-known risk factor for cardiovascular diseases. Several studies have shown that OSA is associated with vessel remodeling, but few studies have examined aorta. Aim: to analyse aortic remodelling in OSA. Methods: Thirty consecutive OSA patients (22 males and 8 females, aged 58.5 ± 13.2 years) were studied. All patients underwent a morning blood gas analysis, a full cardiorespiratory evaluation, including nocturnal polygraphy and echocardiography, that assessed aortic root diameter (ARD) and aortic stiffness index (ASI). Patients were grouped as follows: Group 1, non-severe OSA (Apnea-Hypopnea Index; AHI <30, 14 patients); Group 2, severe OSA (AHI ≥30, 16 patients). Results: No difference was found between the groups in ARD as absolute value (Group 1, 33.64 ± 0.91 mm; Group 2, 33.64 ± 1.02, p = ns) and as normalized value for the body surface area – ARDi (Group 1, 16.72 ± 0.63 mm/m2; Group 2, 16.09 ± 0.44, p = ns). Moreover, no difference was found in the ASI (Group 1, 14.04 ± 2.26; Group 2, 13.41 ± 2.22, p = ns). Considering all OSA patients, AHI showed an inverse correlation with ARDi (p = 0.018) and ASI (p = 0.0449). Moreover, the ASI showed a direct correlation with ARDi (p = 0.01) and morning PaO2 (p = 0.0349) as well as an inverse correlation with the oxygen desaturation index (ODI, p = 0.031) and total time with apnea and hypopnea (p = 0.039). Conclusion: No difference was found between severe and non-severe OSA in ARD. Surprisingly, the data show that the severity of OSA correlates inversely with the ASI and ARDi. The relation between PaO2 and stiffness might be explained by a feedback mechanism that tries to overcome the reduction of aortic elasticity due to night desaturation. These findings need to be investigated in further studies with a larger study population.
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References
Sateia MJ (2014) International classification of sleep disorders-third edition. Chest 146:1387–1394
Lee L-C et al (2010) The relative impact of obstructive sleep apnea and hypertension on the structural and functional changes of the thoracic aorta. Sleep 33:1173–1176
Cuspidi C et al (2014) Aortic root diameter and risk of cardiovascular events in a general population. J Hypertens 32:1879–1887
Oliver JJ, Webb DJ (2003) Noninvasive assessment of arterial stiffness and risk of atherosclerotic events ATVB in focus noninvasive assessment of atherosclerosis: from structure to function noninvasive assessment of arterial stiffness and risk of atherosclerotic events. Arter Thromb Vasc Biol 23:554–566
Narkiewicz K et al (1998) Altered cardiovascular variability in obstructive sleep apnea. Circulation 98:1071–1077
Baguet J-P et al (2011) Increased aortic root size is associated with nocturnal hypoxia and diastolic blood pressure in obstructive sleep apnea. Sleep 34(11): 1605–1607
Kohler M, Stradling JR (2010) Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol 7:677–685
Saruhara H et al (2012) Obstructive sleep apnea as a potential risk factor for aortic disease. Heart Vessel 27:166–173
Zhang T, Zhang X, Zhang C, Chen J, Han F, Guo W (2014) Obstructive sleep apnea syndrome: a risk factor for Stanford’s type B aortic dissection. Ann Vasc Surg 28(8):1901–1908
Kohler M et al (2013) The impact of obstructive sleep apnea on aortic disease in Marfan’s syndrome. Respiration 86:39–44
Tanriverdi H et al (2006) Aortic stiffness, flow-mediated dilatation and carotid intima-media thickness in obstructive sleep apnea: non-invasive indicators of atherosclerosis. Respiration 73:741–750
Altiparmak IH et al (2016) Relation of elastic properties of pulmonary artery with left ventricular abnormalities and aortic stiffness in patients with moderate to severe obstructive sleep apnea: a cross-sectional echocardiographic study. Turk Kardiyol Dern Ars 44:289–299
Korcarz CE, Benca R, Barnet JH, Stein JH (2016) Treatment of obstructive sleep apnea in young and middle-aged adults: effects of positive airway pressure and compliance on arterial stiffness, endothelial function, and cardiac hemodynamics. J Am Heart Assoc 5:1–12
Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH (2011) Aortic stiffness: current understanding and future directions. J Am Coll Cardiol 57(14):1511–1522
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Cicco, S. et al. (2018). Analysis of Aortic Remodeling and Stiffness in Patients with Obstructive Sleep Apnea Syndrome: Preliminary Results. In: Thews, O., LaManna, J., Harrison, D. (eds) Oxygen Transport to Tissue XL. Advances in Experimental Medicine and Biology, vol 1072. Springer, Cham. https://doi.org/10.1007/978-3-319-91287-5_40
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DOI: https://doi.org/10.1007/978-3-319-91287-5_40
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