1. Influence of nocturnal hypoxemia on follow-up course after type B acute aortic syndrome
- Author
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Delsart, P. (Pascal), Soquet, J. (Jerome), Pierache, A. (Adeline), Dedeken, M. (Maxime), Fry, S. (Stephanie), Mallart, A. (Anne), Pontana, F. (Francois), Azzaoui, R. (Richard), Juthier, F. (Francis), Sobocinski, J. (Jonathan), Mounier Vehier, C. (Claire), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 (RNMCD), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 (RNMCD), Institut Coeur Poumon [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Médicaments et biomatériaux à libération contrôlée: mécanismes et optimisation - Advanced Drug Delivery Systems - U 1008 (MBLC - ADDS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Lille, Inserm, CHU Lille, Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires [RNMCD - U1011], Centre d'Infection et d'Immunité de Lille (CIIL) - U1019 - UMR 9017, Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (EGID) - U1011, Advanced Drug Delivery Systems (ADDS) - U1008, and Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,RC705-779 ,Research ,[SDV]Life Sciences [q-bio] ,Nocturnal hypoxemia ,Sleep apnea ,Aortic dissection ,Middle Aged ,Prognosis ,Respiration, Artificial ,Diseases of the respiratory system ,Sleep Apnea Syndromes ,cardiovascular system ,Humans ,Female ,Stents ,France ,Prospective Studies ,Hypoxia ,Aged - 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.
- Published
- 2021
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