Document Detail

The relative impact of obstructive sleep apnea and hypertension on the structural and functional changes of the thoracic aorta.
MedLine Citation:
PMID:  20857863     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recent studies suggest that obstructive sleep apnea (OSA) causes thoracic aortic dilatation; but it is well accepted that hypertension can cause aortic dilatation, and hypertension is a common finding in patients with OSA. We aimed to investigate the relative impact of OSA and hypertension on the structural and functional changes of the thoracic aorta.
METHODS: This was an echocardiography substudy of our prospective OSA study in patients with acute myocardial infarction (AMI). Ninety-four male patients who completed both echocardiography and polysomnography were recruited. OSA was defined as an apnea-hypopnea index (AHI) > or = 15/hour.
RESULTS: The patients' mean age was 53 +/- 10 years, and mean body mass index (BMI) was 24.6 +/- 3 kg/m2. Sixty-four (68.1%) patients had OSA; of these, 39 (41.5%) had severe OSA. Thirty-three (52.6%) of the OSA cohort had hypertension. There was no correlation between any of the echocardiographic parameters and thoracic aortic size. Stepwise multivariate regression showed that BMI (P = 0.024), older age (P = 0.044), and hypertension (P = 0.025) were the only determinants. There was no significant independent relationship between OSA/AHI and thoracic aortic size. Systolic blood pressure but notAHI correlated significantly with aortic distensibility and compliance (r = -0.40 and -0.26, P < 0.001 and 0.022, respectively).
CONCLUSIONS: Hypertension is a common finding in male AMI patients with OSA. In these patients, increased afterload from systemic hypertension rather than mechanical stress on the aortic wall determines the thoracic aortic size and abnormalities in aortic functional indices. BMI and age were also independent predictors of thoracic aortic dilatation.
Li-Ching Lee; Maria Consolacion Torres; See-Meng Khoo; Eric Y Chong; Cindy Lau; Yemon Than; Dong-Xia Shi; Anand Kailasam; Kian-Keong Poh; Chi-Hang Lee; Tiong-Cheng Yeo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Sleep     Volume:  33     ISSN:  0161-8105     ISO Abbreviation:  Sleep     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-22     Completed Date:  2010-12-23     Revised Date:  2011-12-07    
Medline Journal Info:
Nlm Unique ID:  7809084     Medline TA:  Sleep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1173-6     Citation Subset:  IM    
Cardiac Department, National University Hospital, Singapore, National University Health System, Singapore.
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MeSH Terms
Aorta, Thoracic / physiopathology*,  ultrasonography*
Body Mass Index
Cohort Studies
Hypertension / complications*,  physiopathology,  ultrasonography
Middle Aged
Myocardial Infarction / complications,  diagnosis,  therapy
Risk Factors
Severity of Illness Index
Sleep Apnea, Obstructive / complications*,  physiopathology,  ultrasonography
Comment In:
Sleep. 2011;34(11):1605-7   [PMID:  22043131 ]

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