P-wave duration and dispersion during intrathoracic pressure swings

Abstract

Background: The incidence of thoracic aortic aneurysm (TAA) is estimated to be six to ten cases per 100,000 patient years. Sixty percent of TAA involve the ascending aorta (AA). Recent findings from observational studies suggest a possible link between obstructive sleep apnea (OSA), thoracic aortic dilatation and aortic events in patients with Marfan9s syndrome. Whether there is a high prevalence of thoracic aortic aneurysm in patients with OSA is currently unknown. Methods: Patients who underwent in-hospital respiratory polygraphy between 1996 and 2014 and had an echocardiography within the same year were included in this retrospective study. The diagnosis of TAA was defined by the following parameters: AA diameter > 42 mm for females and > 46 mm for males. OSA was defined as mild (apnoea-hypopnoea index (AHI) 5-15/h), moderate (AHI 30/h). Results: 206 patients were included in the analysis. 55 patients (27 %) had mild OSA, 48 patients (23 %) were diagnosed with moderate OSA and 77 patients (37 %) had severe OSA. TAA was identified in 63 of the 206 patients (31 %). The prevalence of TAA was significantly higher in patients with an AHI > 15/h (39 %) when compared to patients with no or mild OSA (21 %) (P=0.0072). Conclusion: This is the first study to determine a high prevalence of TAA in patients with moderate to severe OSA. Prospective controlled cohort studies are needed to investigate whether OSA is associated with faster progression of aortic dilatation and aortic events.