Prognostic Significance of Sleep Apnea Syndrome on False Lumen Aortic Expansion in Post-Acute Aortic Syndrome

Background. Obstructive sleep apnea syndrome (OSAS) is a risk factor for resistant arterial hypertension and aortic dilatation. We assessed the value of systematic screening for OSAS in patients soon after the onset of acute aortic syndrome (AAS). Methods. Between January 2010 and June 2014, patients were prospectively screened for post AAS OSAS. The severity of OSAS was defined by the Apnea-Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI). Blood pressure control was assessed with 24-h ambulatory monitoring. Results. The study population comprised 71 patients (males: 64.7%; median age [interquartile range]: 57 [49 to 64] years; type A AAS: 49.3%; type B AAS: 50.7%). According to the AHI, 58 patients (81.7%) had OSAS and 31 (43.6%) had severe OSAS. A prognostic analysis revealed that the descending thoracic false lumen dilatation rate rose significantly with the severity of OSAS (p= 0.0008 for the AHI and p = 0.0284 for the ODI). The median rate of increase was 7.5 (5 to 10) mm/ year in the AHI greater than 30 events/h group and 5.0 (0 to 8) mm/year in the ODI greater than 30 events/h group. With regard to blood pressure control, the diastolic blood pressure varied as function of the ODI category (p = 0.0074). Conclusions. Our results suggest that systematic screening for post-ASS OSAS is of value. The false lumen dilatation rate appears to be related to the severity of OSAS. It remains to be seen whether treatment of OSAS would modify the false lumen dilatation rate. (C) 2016 by The Society of Thoracic Surgeons