Key result
Obstructive sleep apnea severity (AHI) was significantly and independently correlated with increased aortic knob width (partial r=0.15, p<0.001), suggesting it as a novel indicator of atherosclerosis.
Why the study?
Patients with OSA are prone to arterial stiffness and atherosclerosis, but aortic knob width on chest radiography had not been evaluated in this population.
Is aortic knob width associated with obstructive sleep apnea severity and arterial stiffness in patients undergoing polysomnography?
Cross-Sectional (n=549)
Single-blind (radiograph examiner blinded to clinical data)
No
Is aortic knob width associated with obstructive sleep apnea severity and arterial stiffness in patients undergoing polysomnography?
Effect estimate: partial r = 0.15
p-value: p=<0.001
Aortic knob width on chest radiography is independently associated with OSA severity and arterial stiffness, suggesting its potential as a simple indicator of atherosclerotic changes.
Aortic knob width was associated with OSA severity and vascular stiffness; leaves open its role as a simple radiographic marker pending prospective validation.
AIM: Patients with obstructive sleep apnea (OSA) are likely to show increased arterial stiffness and progressive systemic atherosclerosis. Chest radiography reveals atherosclerotic changes in the aorta via measurement of aortic knob width. However, to our knowledge, aortic knob width in patients with OSA has never been evaluated. METHODS: We measured the aortic knob width in chest radiographs of 549 patients (age: 52.5±13.2 years; 69 women) who underwent overnight polysomnography. Moreover, we evaluated the association between aortic knob width and other clinical characteristics, including cardio-ankle vascular index (CAVI) and apnea-hypopnea index (AHI). Multivariate linear regression analysis was conducted to identify factors associated with aortic knob width. RESULTS: A significant direct correlation between aortic knob width and CAVI and between aortic knob width and AHI was observed. In multivariate linear regression analysis, either CAVI or AHI was independently associated with aortic knob width (p=0.004 and p＜0.001, respectively) in addition to age, male gender, body mass index, and systolic blood pressure. CONCLUSION: A significant independent correlation between aortic knob width and OSA severity was observed. Our findings suggest that an increase in the aortic knob width suggests atherosclerotic changes in the aorta and may be associated with OSA and increased arterial stiffness.
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Tomita et al. (2019) conducted a cross-sectional in Obstructive sleep apnea (n=549). Obstructive sleep apnea severity vs. No obstructive sleep apnea was evaluated on Aortic knob width (partial r = 0.15, p=<0.001). Obstructive sleep apnea severity (AHI) was significantly and independently correlated with increased aortic knob width (partial r=0.15, p<0.001), suggesting it as a novel indicator of atherosclerosis.
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