Influence of nocturnal hypoxemia on follow-up course after type B acute aortic syndrome
Abstract Introduction Association between sleep nocturnal breathing disorders and acute aortic syndrome (AAS) has been described but mid-term data are scarce. Objectives We assessed the prognostic value of sleep apnea parameters and their relationship with aortic morphology after the onset of a type...
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-021-01778-y |
| _version_ | 1818383982138490880 |
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| author | Pascal Delsart Jerome Soquet Adeline Pierache Maxime Dedeken Stephanie Fry Anne Mallart François Pontana Richard Azzaoui Francis Juthier Jonathan Sobocinski Claire Mounier-Vehier |
| author_facet | Pascal Delsart Jerome Soquet Adeline Pierache Maxime Dedeken Stephanie Fry Anne Mallart François Pontana Richard Azzaoui Francis Juthier Jonathan Sobocinski Claire Mounier-Vehier |
| author_sort | Pascal Delsart |
| collection | DOAJ |
| description | Abstract Introduction Association between sleep nocturnal breathing disorders and acute aortic syndrome (AAS) has been described but mid-term data are scarce. Objectives We assessed the prognostic value of sleep apnea parameters and their relationship with aortic morphology after the onset of a type B AAS. Methods Between January 2010 and January 2018, sleep apnea screening in post type B AAS was prospectively performed. The association of sleep apnea parameters with aortic morphology and aortic expansion during follow-up was studied. Results Over the 8-year-study period, 103 patients were included, with a mean age of 57.8 ± 12.1 years old. Median follow-up was 25.0 months (11.0–51.0). Thirty-two patients (31%) required aortic stenting during the acute phase. In patients treated by aortic stenting, the descending thoracic aortic diameter was positively associated with a higher percentage of nocturnal time of saturation ≤ 90% after adjustment (p = 0.016). During follow-up, the nocturnal time of saturation ≤ 90% in patients treated by medical therapy was the only parameter associated with significant aortic expansion rate (r = 0.26, p = 0.04). Thirty-eight patients started and sustained nocturnal ventilation during follow-up. The association between aortic expansion rate and nocturnal time of saturation ≤ 90% did not persist during follow-up after adjustment on nocturnal ventilation initiation (r = 0.25, p = 0.056). Conclusions Nocturnal hypoxemia parameters are positively associated with the max onset aortic diameter and significant aortic growth after type B AAS. Nocturnal ventilation seems to mitigate aortic expansion during follow-up. |
| first_indexed | 2024-12-14T03:15:01Z |
| format | Article |
| id | doaj.art-40d7909a8ebd48eea044fb2750a5033b |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-14T03:15:01Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-40d7909a8ebd48eea044fb2750a5033b2022-12-21T23:19:09ZengBMCBMC Pulmonary Medicine1471-24662021-12-0121111010.1186/s12890-021-01778-yInfluence of nocturnal hypoxemia on follow-up course after type B acute aortic syndromePascal Delsart0Jerome Soquet1Adeline Pierache2Maxime Dedeken3Stephanie Fry4Anne Mallart5François Pontana6Richard Azzaoui7Francis Juthier8Jonathan Sobocinski9Claire Mounier-Vehier10Lille, Institut Cœur PoumonLille, Institut Cœur PoumonService d’épidémiologie et de santé publique, University of Lille, CHU LilleLille, Institut Cœur PoumonLille, Institut Cœur PoumonLille, Institut Cœur PoumonLille, Institut Cœur PoumonLille, Institut Cœur PoumonLille, Institut Cœur PoumonLille, Institut Cœur PoumonLille, Institut Cœur PoumonAbstract Introduction Association between sleep nocturnal breathing disorders and acute aortic syndrome (AAS) has been described but mid-term data are scarce. Objectives We assessed the prognostic value of sleep apnea parameters and their relationship with aortic morphology after the onset of a type B AAS. Methods Between January 2010 and January 2018, sleep apnea screening in post type B AAS was prospectively performed. The association of sleep apnea parameters with aortic morphology and aortic expansion during follow-up was studied. Results Over the 8-year-study period, 103 patients were included, with a mean age of 57.8 ± 12.1 years old. Median follow-up was 25.0 months (11.0–51.0). Thirty-two patients (31%) required aortic stenting during the acute phase. In patients treated by aortic stenting, the descending thoracic aortic diameter was positively associated with a higher percentage of nocturnal time of saturation ≤ 90% after adjustment (p = 0.016). During follow-up, the nocturnal time of saturation ≤ 90% in patients treated by medical therapy was the only parameter associated with significant aortic expansion rate (r = 0.26, p = 0.04). Thirty-eight patients started and sustained nocturnal ventilation during follow-up. The association between aortic expansion rate and nocturnal time of saturation ≤ 90% did not persist during follow-up after adjustment on nocturnal ventilation initiation (r = 0.25, p = 0.056). Conclusions Nocturnal hypoxemia parameters are positively associated with the max onset aortic diameter and significant aortic growth after type B AAS. Nocturnal ventilation seems to mitigate aortic expansion during follow-up.https://doi.org/10.1186/s12890-021-01778-yAortic dissectionNocturnal hypoxemiaSleep apneaPrognosis |
| spellingShingle | Pascal Delsart Jerome Soquet Adeline Pierache Maxime Dedeken Stephanie Fry Anne Mallart François Pontana Richard Azzaoui Francis Juthier Jonathan Sobocinski Claire Mounier-Vehier Influence of nocturnal hypoxemia on follow-up course after type B acute aortic syndrome BMC Pulmonary Medicine Aortic dissection Nocturnal hypoxemia Sleep apnea Prognosis |
| title | Influence of nocturnal hypoxemia on follow-up course after type B acute aortic syndrome |
| title_full | Influence of nocturnal hypoxemia on follow-up course after type B acute aortic syndrome |
| title_fullStr | Influence of nocturnal hypoxemia on follow-up course after type B acute aortic syndrome |
| title_full_unstemmed | Influence of nocturnal hypoxemia on follow-up course after type B acute aortic syndrome |
| title_short | Influence of nocturnal hypoxemia on follow-up course after type B acute aortic syndrome |
| title_sort | influence of nocturnal hypoxemia on follow up course after type b acute aortic syndrome |
| topic | Aortic dissection Nocturnal hypoxemia Sleep apnea Prognosis |
| url | https://doi.org/10.1186/s12890-021-01778-y |
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