Obstructive sleep apnea as a risk factor for the onset and progression of aortic dissection

Background: Aortic dissection is thought to develop and progress due to hypertension and atherosclerosis, but the detailed mechanisms of the onset and progression are still unknown. In this study, we investigated the relationship between type of aortic dissection and the atherosclerotic risk factors including obstructive sleep apnea (OSA) and discussed potential mechanisms. Methods: There were 52 consecutive patients with aortic dissection who were admitted to our hospital, and a sleep study was performed to look for OSA in 42 of them (27 men and 15 women, age: 67±12 years, BMI: 24±4, DeBakey type I: n=6, type IIIa: n=7, type IIIb: n=29). Results: In the 42 patients who had a sleep study, OSA was seen in 36 patients (86%). OSA was more frequent in type IIIb (n=27) than in type IIIa (n=4) aortic dissection (93% vs 57%, p= 0.01). Univariate logistic regression analysis indicated that the presence of OSA could distinguish type IIIb from IIIa (odds ratio: 10.125, 95% confidence interval: 1.272-80.623, P=0.029). Conclusion: OSA was frequently associated with aortic dissection and its prevalence was higher in type IIIb than type IIIa, suggesting that OSA may be associated with the development and progression of aortic dissection.