The impact of obstructive sleep apnea on aortic disease in Marfan's syndrome
Background: Aortic dissection is a life-threatening manifestation of Marfan's syndrome. Preliminary evidence suggests that obstructive sleep apnea (OSA) is associated with aortic disease in Marfan's syndrome. Objectives: To study the effect of OSA on aortic events in Marfan's syndrome...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
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2013
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| _version_ | 1826305823185305600 |
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| author | Kohler, M Senn, O Pitcher, A Forfar, C Blair, E Risby, P Stradling, JR Wordsworth, B |
| author_facet | Kohler, M Senn, O Pitcher, A Forfar, C Blair, E Risby, P Stradling, JR Wordsworth, B |
| author_sort | Kohler, M |
| collection | OXFORD |
| description | Background: Aortic dissection is a life-threatening manifestation of Marfan's syndrome. Preliminary evidence suggests that obstructive sleep apnea (OSA) is associated with aortic disease in Marfan's syndrome. Objectives: To study the effect of OSA on aortic events in Marfan's syndrome. Methods: In patients with Marfan's syndrome, a sleep study was performed at baseline and OSA was defined as >5 events of apnea/hypopnea (A+H) per hour in bed. Operation because of progressive aortic dilatation and death because of aortic rupture were defined as 'aortic events'. Kaplan-Meier survival analyses were used to compare event-free survival in patients with and without OSA. Cox regression models were used to explore the effects of covariates on event-free survival. Results: Data from 44 patients (mean age 37.4 years, 30 females) were available for analysis; 15 patients (34.1%) had OSA. The median follow-up time was 29 (interquartile range 24-36) months. Five patients had an aortic event within the follow-up time. Median event-free survival was 51.6 months. Event-free survival was significantly shorter in patients with OSA compared to patients without OSA (p = 0.012). In univariate analysis, A+H was associated with aortic events [hazard ratio (HR) 1.09, 95% confidence interval (CI) 1.01-1.18, p = 0.023]. Taking the interaction between BMI and A+H into account increased the HR for A+H (HR 1.75, 95% CI 1.003-3.048, p = 0.049). This association was no longer significant when other covariates were forced into the multivariate analysis. Conclusions: These data suggest that aortic event-free survival may be shorter in patients with Marfan's syndrome and OSA compared to patients without OSA, but more data from well-designed studies are needed to prove this association. Copyright © 2012 S. Karger AG, Basel. |
| first_indexed | 2024-03-07T06:38:41Z |
| format | Journal article |
| id | oxford-uuid:f8894bd7-0422-4bc0-89f3-95a1844077d7 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T06:38:41Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:f8894bd7-0422-4bc0-89f3-95a1844077d72022-03-27T12:51:00ZThe impact of obstructive sleep apnea on aortic disease in Marfan's syndromeJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f8894bd7-0422-4bc0-89f3-95a1844077d7Symplectic Elements at Oxford2013Kohler, MSenn, OPitcher, AForfar, CBlair, ERisby, PStradling, JRWordsworth, BBackground: Aortic dissection is a life-threatening manifestation of Marfan's syndrome. Preliminary evidence suggests that obstructive sleep apnea (OSA) is associated with aortic disease in Marfan's syndrome. Objectives: To study the effect of OSA on aortic events in Marfan's syndrome. Methods: In patients with Marfan's syndrome, a sleep study was performed at baseline and OSA was defined as >5 events of apnea/hypopnea (A+H) per hour in bed. Operation because of progressive aortic dilatation and death because of aortic rupture were defined as 'aortic events'. Kaplan-Meier survival analyses were used to compare event-free survival in patients with and without OSA. Cox regression models were used to explore the effects of covariates on event-free survival. Results: Data from 44 patients (mean age 37.4 years, 30 females) were available for analysis; 15 patients (34.1%) had OSA. The median follow-up time was 29 (interquartile range 24-36) months. Five patients had an aortic event within the follow-up time. Median event-free survival was 51.6 months. Event-free survival was significantly shorter in patients with OSA compared to patients without OSA (p = 0.012). In univariate analysis, A+H was associated with aortic events [hazard ratio (HR) 1.09, 95% confidence interval (CI) 1.01-1.18, p = 0.023]. Taking the interaction between BMI and A+H into account increased the HR for A+H (HR 1.75, 95% CI 1.003-3.048, p = 0.049). This association was no longer significant when other covariates were forced into the multivariate analysis. Conclusions: These data suggest that aortic event-free survival may be shorter in patients with Marfan's syndrome and OSA compared to patients without OSA, but more data from well-designed studies are needed to prove this association. Copyright © 2012 S. Karger AG, Basel. |
| spellingShingle | Kohler, M Senn, O Pitcher, A Forfar, C Blair, E Risby, P Stradling, JR Wordsworth, B The impact of obstructive sleep apnea on aortic disease in Marfan's syndrome |
| title | The impact of obstructive sleep apnea on aortic disease in Marfan's syndrome |
| title_full | The impact of obstructive sleep apnea on aortic disease in Marfan's syndrome |
| title_fullStr | The impact of obstructive sleep apnea on aortic disease in Marfan's syndrome |
| title_full_unstemmed | The impact of obstructive sleep apnea on aortic disease in Marfan's syndrome |
| title_short | The impact of obstructive sleep apnea on aortic disease in Marfan's syndrome |
| title_sort | impact of obstructive sleep apnea on aortic disease in marfan s syndrome |
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