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Published ahead of print on August 6, 2003, doi:10.1164/rccm.200304-566OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 12, December 2003, 1528-1531

A more recent version of this article appeared on December 15, 2003
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Submitted on April 24, 2003
Accepted on August 5, 2003

Obstructive sleep apnea and thoracic aorta dissection

Gabriel Sampol1*, Odile Romero2, Armando Salas3, Jose L Tovar4, Patricia Lloberes1, Teresa Sagales2, and Arturo Evangelista3

1 Respiratory, Hospital Universitari Vall d'Hebron, Barcelona, Spain, 2 Neurophysiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain, 3 Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain, 4 Nephrology, Hospital Universitari Vall d'Hebron, Barcelona, Spain

* To whom correspondence should be addressed. E-mail: gsampol{at}vhebron.net.

The Obstructive Sleep Apnea Syndrome (OSAS) is a process associated with the development of arterial hypertension, the main risk factor for aortic dissection and, during obstructive episodes of the upper airways, with marked increases in transmural pressure of the aorta wall. The aim of this work was to study the association between aortic dissection and OSAS. Nineteen consecutive patients with thoracic aorta dissection and 19 hypertensive patients of similar age, sex and body mass index were studied by clinical questionnaire and polysomnography. Snoring and non-refreshing sleep were common in both groups. Thirteen patients (68%) from each group showed an apnea-hypopnea index > 5/hour. However, patients with aortic dissection presented a higher apnea-hypopnea index , 28 (30.3) vs 11.1 (10.4) (p=0.032). Seven patients with dissection presented an apnea-hypopnea index > 30 vs 1 patient in the control group (p=0.042). Patients with thoracic aorta dissection present a high prevalence of previously undiagnosed and frequently severe OSAS. Further studies including this diagnosis as a prognostic variable in the follow-up of patients with aortic dissection are required.Our results suggest that, in patients with aortic dissection and symptoms consistent with OSAS, a sleep study should be considered in their clinical management.
Key words: Obstructive sleep apnea, Sleep, Thoracic aorta




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