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Is obstructive sleep apnea a risk factor for the progression of thoracic aortic aneurysm? A prospective cohort study

Thomas Gaisl, Rejmer Protazy, Maurice Roeder, Patrick Baumgartner, Noriane Sievi, Sandra Siegfried, Simon Stämpfli, Felix Tanner, Malcolm Kohler
European Respiratory Journal 2020 56: 4991; DOI: 10.1183/13993003.congress-2020.4991
Thomas Gaisl
1University Hospital Zurich, Department of Pulmonology, Zürich, Switzerland
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  • For correspondence: thomas.gaisl@usz.ch
Rejmer Protazy
1University Hospital Zurich, Department of Pulmonology, Zürich, Switzerland
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Maurice Roeder
1University Hospital Zurich, Department of Pulmonology, Zürich, Switzerland
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Patrick Baumgartner
1University Hospital Zurich, Department of Pulmonology, Zürich, Switzerland
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Noriane Sievi
1University Hospital Zurich, Department of Pulmonology, Zürich, Switzerland
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Sandra Siegfried
2Department of Biostatistics and Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland
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Simon Stämpfli
3Department of Cardiology, Lucerne Cantonal Hospital, Lucerne, Switzerland
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Felix Tanner
4University Hospital Zurich, Department of Cardiology, Zürich, Switzerland
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Malcolm Kohler
1University Hospital Zurich, Department of Pulmonology, Zürich, Switzerland
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Abstract

Obstructive sleep apnea (OSA) is associated with aortic aneurysms and it has been suggested that severe OSA furthers aneurysm expansion in the abdomen. The aim of this prospective cohort study was to evaluate whether OSA is a risk factor for the progression of thoracic aortic aneurysms (TAA).

A cohort of 245 patients with TAA underwent four annual, standardized echocardiographic measurements of the aorta and level-3 sleep studies at baseline and follow-up. The primary outcome was the yearly expansion rate of TAA in relation to the Apnea-Hypopnea-Index (AHI); the secondary outcomes included aortic events i.e. ruptures, dissections, endovascular repairs or rapid progressions of TAA. ClinicalTrials.gov Identifier: NCT02204774

Between July 2014 and February 2020 all patients completed the protocol and 73% (n=179) underwent all four measurements. At baseline, participants (85% male) had a mean age of 68±12 years, a mean Body-Mass-Index of 27±4 kg/m2, and the mean AHI was 10 (quartiles 4-21) events/hour. Average expansion rates were 0.21 (quartiles 0-0.44) mm/year at the aortic sinus and 0.12 (quartiles 0- 0.40) mm/year at the ascending aorta. In multivariate regression analysis, controlling for cardiovascular risk factors and blood pressure, the AHI remained an independent risk factor for TAA expansion (p<0.001 for the aortic sinus and ascending aorta). 8% (n=20) of participants experienced an aortic event and there was no association with OSA severity.

OSA seems to be an independent risk factor for TAA expansion. A causal relationship remains to be established in a randomized controlled intervention trial.

  • Apnoea / Hypopnea
  • Chronic diseases
  • Circulation

Footnotes

Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4991.

This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2020
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Is obstructive sleep apnea a risk factor for the progression of thoracic aortic aneurysm? A prospective cohort study
Thomas Gaisl, Rejmer Protazy, Maurice Roeder, Patrick Baumgartner, Noriane Sievi, Sandra Siegfried, Simon Stämpfli, Felix Tanner, Malcolm Kohler
European Respiratory Journal Sep 2020, 56 (suppl 64) 4991; DOI: 10.1183/13993003.congress-2020.4991

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Is obstructive sleep apnea a risk factor for the progression of thoracic aortic aneurysm? A prospective cohort study
Thomas Gaisl, Rejmer Protazy, Maurice Roeder, Patrick Baumgartner, Noriane Sievi, Sandra Siegfried, Simon Stämpfli, Felix Tanner, Malcolm Kohler
European Respiratory Journal Sep 2020, 56 (suppl 64) 4991; DOI: 10.1183/13993003.congress-2020.4991
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