Sleep apnea and the impact on cardiovascular risk in patients with Marfan syndrome

Mol Genet Genomic Med. 2019 Aug;7(8):e805. doi: 10.1002/mgg3.805. Epub 2019 Jun 27.

Abstract

Background: Marfan syndrome (MFS) is an inherited connective tissue disorder characterized by ectopia lentis, aortic root dilation and dissection and specific skeletal features. Obstructive sleep apnea (OSA) in MFS has been described earlier but the prevalence and its relation with the cardiovascular risk is still controversial. This study aimed to further investigate these aspects.

Methods: In this prospective longitudinal study, we performed an attended polysomnography in 40 MFS patients (60% women, 37 ± 12.8 years) and evaluated several cardiovascular parameters through echocardiography, resting electrocardiogram, 24 hr-Holter monitoring and serum NT-ProBNP measurements.

Results: We found that OSA was present in 42.5% of the patients and that higher body mass index was the most important factor associated with the presence of OSA. We observed that overweight was present in 27.5% of the patients in the whole cohort and in 55.6% if >40 years. Furthermore, when evaluating the impact of OSA on the cardiovascular system, we observed that patients with OSA tended to have higher systolic blood pressure, larger distal aortic diameters and a higher prevalence of ventricular arrhythmia. These differences were, however, not significant after adjusting for confounders.

Conclusions: Our study shows a high prevalence of OSA and a high prevalence of overweight in MFS patients. We found some trends between OSA and cardiovascular features but we could not establish a solid association. Our study, however might be underpowered, and a multicenter collaborative study could be very useful to answer some important open questions.

Keywords: Marfan syndrome; aortic aneurysm; aortic dissection; arrhythmia; cardiovascular risk; sleep apnea.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aortic Aneurysm / complications
  • Aortic Aneurysm / epidemiology
  • Aortic Dissection / complications
  • Aortic Dissection / epidemiology
  • Arrhythmias, Cardiac / complications
  • Arrhythmias, Cardiac / epidemiology
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Electrocardiography
  • Female
  • Fibrillin-1 / genetics
  • Genetic Association Studies
  • Humans
  • Male
  • Marfan Syndrome / complications*
  • Marfan Syndrome / diagnosis
  • Marfan Syndrome / epidemiology*
  • Marfan Syndrome / genetics
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Polysomnography
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Sleep Apnea Syndromes / complications*
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / epidemiology*
  • Sleep Apnea, Obstructive
  • Young Adult

Substances

  • FBN1 protein, human
  • Fibrillin-1
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain