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Linkage of sleep-disordered breathing and acute aortic dissection with patent false lumen

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Abstract

Sleep-disordered breathing (SDB) is known as a cardiovascular risk factor and has high prevalence in hypertension, which is a major risk factor of aortic dissection (AD). However, the impact of SDB on AD has not been fully clarified. The aim of this study is to elucidate the impact of SDB on AD, especially on the type of false lumen in AD. We enrolled twenty-three consecutive patients with acute AD (mean age: 66 ± 13 years). All subjects were evaluated by an ambulatory polygraphic sleep monitoring within 1 month from the onset. AD was evaluated by axial images of computed tomography. We comparatively analyzed SDB and AD. 35 % of the subjects presented severe OSA (apnea–hypopnea index: AHI ≥30). The patent false lumen group showed significantly higher systolic and diastolic blood pressure (BP) on arrival and AHI, and lower percutaneous oxygen saturation (SaO2) compared with those in the thrombosed false lumen group. The prevalence of severe SDB was higher in the patent false lumen group (60 vs 15 %, p = 0.039). Systolic BP on arrival was significantly correlated with AHI (r = 0.457, p = 0.033) and the minimum SaO2 (r = −0.537, p = 0.010). The present study revealed close linkage between SDB and AD, and a high prevalence of SDB among AD patients. Severe SDB was related to the development of AD, especially for the patent false lumen type through highly elevated BP which might be easily evoked in the presence of severe SDB. Repetitive occurrence of intrathoracic negative pressure also might influence the repair or closure of false lumen of AD, although the present analysis did not reach statistical significance.

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Abbreviations

AD:

Aortic dissection

SDB:

Sleep-disordered breathing

OSA:

Obstructive sleep apnea

BP:

Blood pressure

CPAP:

Continuous positive airway pressure

SaO2 :

Percutaneous oxygen saturation

AHI:

Apnea–hypopnea index

ODI:

Oxygen desaturation index

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Authors and Affiliations

  1. Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamagari, Inzai, Chiba, 270-1694, Japan

    Toru Inami, Yoshihiko Seino, Tetsuro Shimura, Osamu Kurihara, Nakahisa Kimata, Daisuke Murakami, Ryo Munakata, Masamichi Takano & Takayoshi Ohba

  2. Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan

    Wataru Shimizu

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  1. Toru Inami
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  2. Yoshihiko Seino
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Correspondence to Toru Inami.

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Inami, T., Seino, Y., Shimura, T. et al. Linkage of sleep-disordered breathing and acute aortic dissection with patent false lumen. Heart Vessels 31, 1069–1076 (2016). https://doi.org/10.1007/s00380-015-0699-4

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  • DOI: https://doi.org/10.1007/s00380-015-0699-4

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