Obstructive sleep apnea in patients with abdominal aortic aneurysms: highly prevalent and associated with aneurysm expansion.

Journal article

RATIONALE: Abdominal aortic aneurysms (AAA) are associated with life-threatening complications. The likelihood that an AAA will rupture is influenced by the aneurysm diameter and its expansion rate; reasons for rapid expansion are largely unknown. OBJECTIVES: To determine the prevalence of obstructive sleep apnea (OSA) in patients with AAA, and investigate a possible association between OSA and rate of AAA expansion. METHODS: A total of 127 patients (11 females), included in an AAA surveillance program, agreed to participate and underwent a sleep study. Annual AAA expansion was determined retrospectively from available ultrasound measurements. OSA was characterized using both oxygen desaturation index (ODI) and apnea-hypopnea index (AHI). Univariate and multivariate analysis was performed to assess the effect of OSA severity on AAA expansion. MEASUREMENTS AND MAIN RESULTS: Mean age was 67.9 (SD, 6) years. Median interval between the first and last AAA measurements was 18 (range, 2-113) months. An ODI or AHI of greater than 10 was found in 40.5% and 41.5% of the patients, respectively. Patients with an ODI greater than 30 (n = 12) had a significantly faster median yearly AAA expansion rate (2.9; quartiles 2/5.7 mm/y) than patients with an ODI 0-5 (n = 47; 1.2; quartiles 0/3.1 mm/y) or 6-15 (n = 43; 1.3; quartiles 0/2.7 mm/y) (P < 0.05). In multivariate regression analysis, controlling for cardiovascular risk factors and medications, ODI greater than 30 remained an independent risk factor for AAA expansion. CONCLUSIONS: In patients with AAA, OSA is highly prevalent. Severe OSA may be a causal factor for faster AAA expansion, but this needs to be proved in a randomized controlled intervention trial.

Authors: Mason, R; Ruegg, G; Perkins, J; Hardinge, M; Amann-Vesti, B

• Publication status: Published
• Journal: American journal of respiratory and critical care medicine
• Volume: 183
• Issue: 5
• Pages: 668-674
• Publication date: 2011-03-01
• DOI: 10.1164/rccm.201001-0051oc
• EISSN: 1535-4970
• ISSN: 1073-449X
• Language: English
• Keywords: Humans; Body Weights and Measures; Sleep Apnea, Obstructive; Retrospective Studies; Male; Comorbidity; Prevalence; Severity of Illness Index; Adult; Middle Aged; Cohort Studies; Aorta, Abdominal; Risk Factors; Great Britain; Aortic Aneurysm, Abdominal; Switzerland; Follow-Up Studies; Aged; Female