Aortic arch calcification is strongly associated with obstructive sleep apnea

Yıl 2021, Cilt: 4 Sayı: 6, 779 - 783, 24.09.2021

Çağrı Zorlu

https://doi.org/10.32322/jhsm.948441

Öz

Aim: Obstructive sleep apnea (OSA) is a common clinical condition that causes an increase in cardiovascular morbidity and mortality. OSA is likely to show increased arterial stiffness and progressive systemic atherosclerosis. Chest radiography reveals atherosclerotic changes in the aorta.The aim of this study was to investigate the relationship between aortic arch calcification (AAC) on chest radiography and OSA.
Material and Method: 204 patients (age: 55±14 years; 78 men) who were diagnosed with OSA by performing night polysomnography were evaluated. On the other hand 200 (age: 48±15 years; 94 men) patients were selected to the group non OSA. AAC was evaluated with chest radiography and inter-observer agreement was analyzed by using kappa statistics. Univariate and multivariate logistic regression analysis was conducted to assess the association of AAC and OSA. P-value <0.05 was considered statistically significant.
Result: The prevalence of AAC was 207 (51,2%). OSA group had significantly higher prevalence of AAC (79% vs. 32.5%, p <0.0001) as compared to the normal group. Presence of AAC was a strong and independent predictor of OSA (OR 3.923, 95%CI 2.396 to 6.328) in multivariate analysis.
Conclusion: Presence of AAC on plain chest radiography is strongly and independently associated with the presence of OSA.

Anahtar Kelimeler

Aorta, Thoracic, Calcinosis, Sleep apnea, Obstructive

Kaynakça

• Somers VK, White DP, Amin R. Sleep apnea and cardiovascular disease. Circulation 2008; 118: 1080–111.
• Kepez A, Niksarlıoğlu EY, Hazırolan T, et al. Evaluation of association between obstructive sleep apnea and coronary risk scores predicted by tomographic coronary calcium scoring in asymptomatic patients. Anadolu Kardiyol Derg 2011: 428-35.
• Kasai T, Floras JS, Bradley TD. Sleep apnea and cardiovascular disease: A bidirectional relationship. Circulation 2012; 126: 1495–510.
• Korkmaz L, Adar A, Korkmaz A, et al. Aortic knob calcification and coronary artery lesion complexity in non-ST-segment elevation acute coronary syndrome patients. Turk Kardiyol Dern Ars 2012; 40: 606-11.
• Sorajja D, Gami AS, Somers VK. Independent association between obstructive sleep apnea and subclinical coronary artery disease. Chest 2008; 133: 927–33.
• Pressman GS, Crudu V, Parameswaran-Chandrika A, RomeroCorral A, Purushottam B, Figueredo VM. Can total cardiac calcium predict the coronary calcium score? Int J Cardiol 2011; 146: 202–6.
• Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150: 604-12.
• Silber MH, Ancoli-Israel S, Bonnet MH, et al. The visual scoring of sleep in adults. J Clin Sleep Med 2007; 3: 121-31.
• Symeonidis G, Papanas N, Giannakis I, et al. Gravity of aortic arch calcification as evaluated in adult Greek patients. Int Angiol 2002; 21: 233-6.
• Sahn D.J, Maris A, Kisslo J. For the committee on M-mode standardization of the American Society of Echocardiography Recommendation regarding quantitation in M-mode echocardiographic measurements. Circulation 1978; 58: 1072-83.
• Strauss RS, Browner WS. Risk for obstructive sleep apnea. Ann Intern Med 2000; 132: 758-9.
• Hedner J, Grote L. Cardiovascular consequences of obstructive sleep apnea. Eur Respir Mon 1998; 10: 227-65.
• Phillips B. Sleep-disordered breathing and cardiovascula rdisease. Sleep Med Rev 2005; 9: 131-40.
• Paris JM, Somers VK. Obstructive sleep apnea and cardiovascular disease. Mayo Clin Proc 2004; 79: 1036-46.
• Yokoe T, Minoguchi K, Matsuo H. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive air way pressure. Circulation 2003;107: 1129- 33.
• Schäfer H, Koehler U, Ploch T, Peter JH. Sleep-related myocardial ischemia and sleep structure in patients with obstructive sleep apnea and coronary heart disease. Chest 1997; 111: 387-93.
• Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med 2002; 165: 677-82.
• Coughlin SR, Mawdsley L, Mugarza JA. Obstructive sleep apnea is indepently associated with an increased prevalence of metabolic syndrome Eur Heart J 2004; 25: 735-41.
• Mintz GS, Popma JJ, Pichard AD, et al. Patterns of calcification in coronary artery disease. A statistical analysis of intravascular ultrasound and coronary angiography in 1155 lesions. Circulation. 1995; 91: 1959-65.
• Stary HC, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Arterioscler Thromb Vasc Biol 1995; 15: 1512-31.
• Kinoshita T, Yahaba M, Terada J, et al. Impact of arterial stiffness on WatchPAT variables in patients with obstructive sleep apnea. J Clin Sleep Med 2018; 14: 319-25.
• Drager LF, Bortolotto LA, Figueiredo AC, Krieger EM, Lorenzi GF. Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit CareMed 2007; 176: 706-12.
• Shpilsky D, Erqou S, Patel SR, et al. Association of obstructive sleep apnea with microvascular endothelial dysfunction and subclinical coronary artery disease in a community-based population. Vasc Med 2018; 23: 331-9.
• Mason RH, Ruegg G, Perkins J, et al. Obstructive sleep apnea in patients with abdominal aortic aneurysms: highly prevalent and associated with aneurysm expansion. Am J Respir Crit Care Med 2011; 183: 668-74.
• Korkmaz L, Erkan H, Korkmaz AA, et al. Relationship of aortic knob width with cardio-ankle vascular stiffness index and its value in diagnosis of subclinical atherosclerosis in hypertensive patients: a study on diagnostic accuracy. Anadolu Kardiyol Derg 2012; 12: 102-6.
• Bos D, Leening MJ, Kavousi M, et al. Comparison of atherosclerotic calcification in major vessel beds on the risk of all-cause and cause-specific mortality: The Rotterdam study. Circ Cardiovasc Imaging 2015; 8: e003843.
• Tomita Y, Kasai T, Ishiwata S, Daida H, Narui K. Aortic knob width as a novel ındicator of atherosclerosis and obstructive sleep apnea. J Atheroscler Thromb 2020; 27: 501-8.
• Zylla S, Dörr M, Völzke H, et al. Association of circulating chemerin with subclinical parameters of atherosclerosis: results of a population-based study. Arterioscler Thromb Vasc Biol 2018; 38: 1656-64.
• Franzago M, Fraticelli F, DiNicola M, et al E. Early subclinical atherosclerosis in gestational diabetes: the predictive role of routine biomarkers and nutrigenetic variants. J Diabetes Res 2018; 2018: 9242579.