Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, P. R. China.
Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, P. R. China.
BMC Cardiovasc Disord. 2022 Jul 24;22(1):329. doi: 10.1186/s12872-022-02775-7.
Patients suffering from aortic dissection (AD) often experience sleep apnea syndrome (SAS), which aggravates their respiratory function and aortic false lumen expansion.
We analyzed the peri-operative data of Stanford A AD patients, with or without SAS, between January 2017 and June 2019. Subjects were separated into SAS positive (SAS) and SAS negative (SAS) cohorts, based on the Apnea-Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI). We next analyzed variables between the SAS and SAS groups.
155, out of 198 AAD patients, were enlisted for this study. SAS patients exhibited higher rates of pneumonia (p < 0.001), heart failure (HF, p = 0.038), acute kidney injury (AKI, p = 0.001), ventilation time (p = 0.009), and hospitalization duration (p < 0.001). According to subsequent follow-ups, the unstented aorta false lumen dilatation (FLD) rate increased markedly, with increasing degree of SAS (p < 0.001, according to AHI and ODI). The SAS patients exhibited worse cumulative survival rate (p = 0.025). The significant risk factors (RF) for poor survival were: severe (p = 0.002) or moderate SAS (p = 0.008), prolonged ventilation time (p = 0.018), AKI (p = 0.015), HF New York Heart Association (NYHA) IV (p = 0.005) or III (p = 0.015), pneumonia (p = 0.005), Marfan syndrome (p = 0.010), systolic blood pressure (BP) upon arrival (p = 0.009), and BMI ≥ 30 (p = 0.004).
SAS Stanford A AD patients primarily exhibited higher rates of complications and low survival rates in the mid-time follow-up. Hence, the RFs associated with poor survival must be monitored carefully in SAS patients. Moreover, the FLD rate is related to the degree of SAS, thus treating SAS may mitigate FLD.
患有主动脉夹层 (AD) 的患者常伴有睡眠呼吸暂停综合征 (SAS)，这会加重其呼吸功能和主动脉假腔的扩张。
我们分析了 2017 年 1 月至 2019 年 6 月期间患有 Stanford A 型 AD 的患者的围手术期数据，这些患者中有些患有 SAS，有些则没有。根据呼吸暂停低通气指数 (AHI) 和氧减指数 (ODI)，患者被分为 SAS 阳性 (SAS) 和 SAS 阴性 (SAS) 两组。然后我们分析了 SAS 组和 SAS 组之间的变量。
本研究共纳入 198 例 AAD 患者中的 155 例。SAS 患者肺炎发生率更高（p<0.001）、心力衰竭（HF，p=0.038）、急性肾损伤（AKI，p=0.001）、通气时间（p=0.009）和住院时间（p<0.001）更长。根据随后的随访，未支架主动脉假腔扩张（FLD）率随着 SAS 程度的增加而明显增加（根据 AHI 和 ODI，p<0.001）。SAS 患者的累积生存率更差（p=0.025）。生存不良的显著危险因素（RF）为：严重（p=0.002）或中度 SAS（p=0.008）、通气时间延长（p=0.018）、AKI（p=0.015）、HF 纽约心脏协会（NYHA）IV 级（p=0.005）或 III 级（p=0.015）、肺炎（p=0.005）、马凡综合征（p=0.010）、入院时收缩压（BP）（p=0.009）和 BMI≥30（p=0.004）。
SAS Stanford A AD 患者主要表现为并发症发生率较高，中期随访生存率较低。因此，SAS 患者必须密切监测与不良生存相关的 RF。此外，FLD 率与 SAS 程度有关，因此治疗 SAS 可能会减轻 FLD。
