{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:23:08Z","timestamp":1791177788902,"version":"4.1.0"},"reference-count":103,"publisher":"European Respiratory Society (ERS)","issue":"2","funder":[{"name":"Clinical Research Priority Program (CRPP) Sleep and Health from the University of Zurich"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2015,4,29]]},"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:p>Obstructive sleep apnoea (OSA) has been shown to be a causal factor in the pathogenesis of vascular dysfunction and hypertension, conditions which can promote dilation and subsequent aortic dissection and rupture. The objective of this review is to summarise the current literature on the possible association between OSA and aortic disease and delineate the underlying mechanisms.<\/jats:p><jats:p>Relevant studies were found by searching for terms including \u201cobstructive sleep apnoea\u201d in combination with \u201caortic aneurysm, dissection, and dilation\u201d in the MEDLINE and EMBASE databases.<\/jats:p><jats:p>Observational studies consistently reported that OSA is highly prevalent among patients with aortic aneurysms and aortic dissections. Patients with co-occurring OSA and Marfan's syndrome as well as patients at the more severe end of the spectrum of OSA seem to be especially vulnerable to aortic disease.<\/jats:p><jats:p>Several mechanisms are discussed concerning the link between OSA and aortic disease: nocturnal negative intrathoracic pressure surges leading to mechanical stretching of the aorta and ultimately aortic distension; arousal-induced reflex sympathetic activation with subsequent hypertension; and intermittent hypoxia associated with autonomic nervous system activation and consequently increased oxidative stress. Further well controlled studies are needed in order to define the exact role of OSA as a risk factor for aortic disease.<\/jats:p>","DOI":"10.1183\/09031936.00029315","type":"journal-article","created":{"date-parts":[[2015,7,3]],"date-time":"2015-07-03T16:27:09Z","timestamp":1435940829000},"page":"532-544","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":65,"title":["The impact of obstructive sleep apnoea on the aorta"],"prefix":"10.1183","volume":"46","author":[{"given":"Thomas","family":"Gaisl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Bratton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Kohler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2015,6,25]]},"reference":[{"key":"2024102023351330000_46.2.532.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199304293281704"},{"key":"2024102023351330000_46.2.532.2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1996.00440200055007"},{"key":"2024102023351330000_46.2.532.3","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"key":"2024102023351330000_46.2.532.4","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00043-0"},{"key":"2024102023351330000_46.2.532.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.901801"},{"key":"2024102023351330000_46.2.532.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71141-7"},{"key":"2024102023351330000_46.2.532.7","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200911-1746OC"},{"key":"2024102023351330000_46.2.532.8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000132"},{"key":"2024102023351330000_46.2.532.9","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.8.757"},{"key":"2024102023351330000_46.2.532.10","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1038\/nrcardio.2010.145","article-title":"Mechanisms of vascular damage in obstructive sleep apnea","volume":"7","author":"Kohler","year":"2010","journal-title":"Nat Rev Cardiol"},{"key":"2024102023351330000_46.2.532.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005113421901"},{"key":"2024102023351330000_46.2.532.12","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.14.1829"},{"key":"2024102023351330000_46.2.532.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)10532-9"},{"key":"2024102023351330000_46.2.532.14","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-011-0543-8"},{"key":"2024102023351330000_46.2.532.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07445-7"},{"key":"2024102023351330000_46.2.532.16","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-0085"},{"key":"2024102023351330000_46.2.532.17","doi-asserted-by":"publisher","DOI":"10.1067\/mva.1991.26737"},{"key":"2024102023351330000_46.2.532.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.05.039"},{"key":"2024102023351330000_46.2.532.19","doi-asserted-by":"publisher","DOI":"10.1007\/s380-002-8315-1"},{"key":"2024102023351330000_46.2.532.20","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.10.1425"},{"key":"2024102023351330000_46.2.532.21","unstructured":"National Center for Injury Prevention and Control. WISQARS Leading Causes of Death Reports, 1999\u20132007. http:\/\/webappa.cdc.gov\/sasweb\/ncipc\/leadcaus10.html Date last updated: June 1, 2010. Date last accessed: April 21, 2015."},{"key":"2024102023351330000_46.2.532.22","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000154569.08857.7A"},{"key":"2024102023351330000_46.2.532.23","first-page":"1103","article-title":"Thoracic aortic aneurysms: a population-based study","volume":"92","author":"Bickerstaff","year":"1982","journal-title":"Surgery"},{"key":"2024102023351330000_46.2.532.24","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199702000-00003"},{"key":"2024102023351330000_46.2.532.25","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.85.1.205"},{"key":"2024102023351330000_46.2.532.26","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.7.897"},{"key":"2024102023351330000_46.2.532.27","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2009.56"},{"key":"2024102023351330000_46.2.532.28","first-page":"246","article-title":"Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study","volume":"108","author":"Young","year":"2009","journal-title":"WMJ"},{"key":"2024102023351330000_46.2.532.29","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.3.734"},{"key":"2024102023351330000_46.2.532.30","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-126-6-199703150-00004"},{"key":"2024102023351330000_46.2.532.31","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2003.007161"},{"key":"2024102023351330000_46.2.532.32","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.16.2013"},{"key":"2024102023351330000_46.2.532.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2004.03.002"},{"key":"2024102023351330000_46.2.532.34","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.5.1455"},{"key":"2024102023351330000_46.2.532.35","doi-asserted-by":"publisher","DOI":"10.1080\/000164800750000658"},{"key":"2024102023351330000_46.2.532.36","doi-asserted-by":"publisher","DOI":"10.1378\/chest.110.5.1184"},{"key":"2024102023351330000_46.2.532.37","doi-asserted-by":"publisher","DOI":"10.1378\/chest.108.3.631"},{"key":"2024102023351330000_46.2.532.38","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1038\/nrcardio.2010.31","article-title":"Marfan syndrome. Part 2: treatment and management of patients","volume":"7","author":"Ca\u00f1adas","year":"2010","journal-title":"Nat Rev Cardiol"},{"key":"2024102023351330000_46.2.532.39","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197204132861502"},{"key":"2024102023351330000_46.2.532.40","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/147.3.645"},{"key":"2024102023351330000_46.2.532.41","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.102756"},{"key":"2024102023351330000_46.2.532.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.01.369"},{"key":"2024102023351330000_46.2.532.43","doi-asserted-by":"publisher","DOI":"10.1159\/000340008"},{"key":"2024102023351330000_46.2.532.44","doi-asserted-by":"publisher","DOI":"10.1159\/000093531"},{"key":"2024102023351330000_46.2.532.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.039"},{"key":"2024102023351330000_46.2.532.46","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2008.06.007"},{"key":"2024102023351330000_46.2.532.47","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1093\/sleep\/33.9.1173","article-title":"The relative impact of obstructive sleep apnea and hypertension on the structural and functional changes of the thoracic aorta","volume":"33","author":"Lee","year":"2010","journal-title":"Sleep"},{"key":"2024102023351330000_46.2.532.48","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-2335"},{"key":"2024102023351330000_46.2.532.49","doi-asserted-by":"publisher","DOI":"10.1177\/147323001103900619"},{"key":"2024102023351330000_46.2.532.50","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.06.006"},{"key":"2024102023351330000_46.2.532.51","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.5665\/sleep.1406","article-title":"Increased aortic root size is associated with nocturnal hypoxia and diastolic blood pressure in obstructive sleep apnea","volume":"34","author":"Baguet","year":"2011","journal-title":"Sleep"},{"key":"2024102023351330000_46.2.532.52","doi-asserted-by":"crossref","first-page":"57","DOI":"10.5664\/jcsm.3360","article-title":"Influence and predicting variables of obstructive sleep apnea on cardiac function and remodeling in patients without congestive heart failure","volume":"10","author":"Chen","year":"2014","journal-title":"J Clin Sleep Med"},{"key":"2024102023351330000_46.2.532.53","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.05.044"},{"key":"2024102023351330000_46.2.532.54","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200304-566OC"},{"key":"2024102023351330000_46.2.532.55","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-011-0149-x"},{"key":"2024102023351330000_46.2.532.56","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2014.07.014"},{"key":"2024102023351330000_46.2.532.57","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.oa.12.02014"},{"key":"2024102023351330000_46.2.532.58","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-011-0060-1"},{"key":"2024102023351330000_46.2.532.59","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201001-0051OC"},{"key":"2024102023351330000_46.2.532.60","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-014-1053-2"},{"key":"2024102023351330000_46.2.532.61","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-011-0135-3"},{"key":"2024102023351330000_46.2.532.62","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-2799"},{"key":"2024102023351330000_46.2.532.63","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00439.2013"},{"key":"2024102023351330000_46.2.532.64","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.02.031"},{"key":"2024102023351330000_46.2.532.65","doi-asserted-by":"publisher","DOI":"10.1378\/chest.95.4.735"},{"key":"2024102023351330000_46.2.532.66","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003093421001"},{"key":"2024102023351330000_46.2.532.67","doi-asserted-by":"publisher","DOI":"10.1097\/00125817-200205000-00003"},{"key":"2024102023351330000_46.2.532.68","doi-asserted-by":"publisher","DOI":"10.1038\/ng1511"},{"key":"2024102023351330000_46.2.532.69","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055695"},{"key":"2024102023351330000_46.2.532.70","doi-asserted-by":"publisher","DOI":"10.1159\/000072559"},{"key":"2024102023351330000_46.2.532.71","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1152\/jappl.1988.64.4.1506","article-title":"Transient analysis of cardiopulmonary interactions. I. Diastolic events","volume":"64","author":"Peters","year":"1988","journal-title":"J Appl Physiol"},{"key":"2024102023351330000_46.2.532.72","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1152\/jappl.1988.64.4.1518","article-title":"Transient analysis of cardiopulmonary interactions. II. Systolic events","volume":"64","author":"Peters","year":"1988","journal-title":"J Appl Physiol"},{"key":"2024102023351330000_46.2.532.73","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-005-0015-0"},{"key":"2024102023351330000_46.2.532.74","unstructured":"Rhoades RA , Bell DR , eds. Medical Physiology: Principles for Clinical Medicine. 4th Edn. Philadelphia, Lippincott Williams and Wilkins, 2013."},{"key":"2024102023351330000_46.2.532.75","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000150859.47929.8e"},{"key":"2024102023351330000_46.2.532.76","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1152\/jappl.1994.77.4.1602","article-title":"Decrease in ventricular stroke volume at apnea termination is independent of oxygen desaturation","volume":"77","author":"Garpestad","year":"1994","journal-title":"J Appl Physiol"},{"key":"2024102023351330000_46.2.532.77","doi-asserted-by":"publisher","DOI":"10.1172\/JCI118235"},{"key":"2024102023351330000_46.2.532.78","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.21.2607"},{"key":"2024102023351330000_46.2.532.79","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.6.1763"},{"key":"2024102023351330000_46.2.532.80","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e32801092c1"},{"key":"2024102023351330000_46.2.532.81","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200703-500OC"},{"key":"2024102023351330000_46.2.532.82","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1152\/jappl.1995.79.2.581","article-title":"Surges of muscle sympathetic nerve activity during obstructive apnea are linked to hypoxemia","volume":"79","author":"Leuenberger","year":"1995","journal-title":"J Appl Physiol"},{"key":"2024102023351330000_46.2.532.83","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200612-1771OC"},{"key":"2024102023351330000_46.2.532.84","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200702-238OC"},{"key":"2024102023351330000_46.2.532.85","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.37.2.511"},{"key":"2024102023351330000_46.2.532.86","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-199715120-00060"},{"key":"2024102023351330000_46.2.532.87","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.5.1674"},{"key":"2024102023351330000_46.2.532.88","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00137107"},{"key":"2024102023351330000_46.2.532.89","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.07.039"},{"key":"2024102023351330000_46.2.532.90","doi-asserted-by":"publisher","DOI":"10.1258\/vasc.2011.201207"},{"key":"2024102023351330000_46.2.532.91","doi-asserted-by":"publisher","DOI":"10.1177\/1538574408315205"},{"key":"2024102023351330000_46.2.532.92","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.5664\/jcsm.3070","article-title":"Serum inflammatory markers in obstructive sleep apnea: a meta-analysis","volume":"9","author":"Nadeem","year":"2013","journal-title":"J Clin Sleep Med"},{"key":"2024102023351330000_46.2.532.93","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.741512"},{"key":"2024102023351330000_46.2.532.94","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.08.084"},{"key":"2024102023351330000_46.2.532.95","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.0000245819.32762.cb"},{"key":"2024102023351330000_46.2.532.96","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.3.1580"},{"key":"2024102023351330000_46.2.532.97","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00184-0"},{"key":"2024102023351330000_46.2.532.98","doi-asserted-by":"publisher","DOI":"10.1378\/chest.101.6.1526"},{"key":"2024102023351330000_46.2.532.99","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000654"},{"key":"2024102023351330000_46.2.532.100","first-page":"245","article-title":"Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: implications for future interventions","volume":"131","author":"Weaver","year":"2010","journal-title":"Indian J Med Res"},{"key":"2024102023351330000_46.2.532.101","doi-asserted-by":"publisher","DOI":"10.1378\/chest.111.6.1763"},{"key":"2024102023351330000_46.2.532.102","doi-asserted-by":"publisher","DOI":"10.1046\/j.0009-9163.2002.00002.x"},{"key":"2024102023351330000_46.2.532.103","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2004.12.009"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/09031936.00029315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:58:17Z","timestamp":1740380297000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/09031936.00029315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,25]]},"references-count":103,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2015,7,31]]},"published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1183\/09031936.00029315"],"URL":"https:\/\/doi.org\/10.1183\/09031936.00029315","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,25]]}}}