{"doi":"10.1093/ajh/hpac019","title":"Adverse Thoracic Aortic Remodeling in Obstructive Sleep Apnea","abstract":"Obstructive sleep apnea (OSA) is associated with various cardiovascular conditions, including hypertension, arrhythmias, coronary artery disease, and pulmonary hypertension.1 Multiple mechanisms for these associations have been proposed, including intermittent hypoxia, changes in intrathoracic pressure, activation of the sympathetic nervous system, and inflammation.2,3 The presence of negative intrathoracic pressure during apneic episodes also favors an increased pressure difference across the aortic wall, which may contribute to thoracic aortic remodeling and enlargement.4 The association between OSA and thoracic aortic size has been evaluated in prior studies, but these analyses have been limited by small sample sizes, and the relationship remains unclear.5 In this issue of the American Journal of Hypertension, Gherbesi et al.5 conducted a systematic review and meta-analysis to comprehensively assess whether OSA is indeed associated with thoracic aortic dilatation. The authors identified 11 studies which in total included 1,862 patients diagnosed with OSA and without connective tissue diseases or known aortic pathology. Most of these studies utilized echocardiography (n = 8), followed by computed tomography (n = 2) and magnetic resonance imaging (n = 1), to measure thoracic aortic diameter. Of these 11 studies, 5 studies compared aortic root and ascending aorta diameters in patients with and without OSA, and a meta-analysis of these 5 studies revealed larger aortic diameters in the OSA group when compared with the control group (standard means difference: 0.73 ± 0.08 mm, confidence interval: 0.57–0.88, P < 0.0001). In these studies, the authors found that systolic blood pressure had a modest positive correlation with aortic diameter (r = 0.29, P < 0.001). Four studies compared aortic sizes across differing severities of OSA, and a meta-analysis of these studies found increased aortic diameters in severe OSA group as opposed to mild OSA (standard means difference: 0.42 ± 0.07 mm, confidence interval: 0.28–0.56, P < 0.0001). Participants in the severe OSA group were also noted to have higher body mass index than the participants in the mild OSA group.","journal":"American Journal of Hypertension","year":2022,"id":294978,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9649,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":228821,"name":"Julio A. Chirinos","orcid":"0000-0001-9035-5670","position":1,"is_corresponding":false},{"id":770364,"name":"Mahesh Vidula","orcid":"0000-0002-7701-8757","position":0,"is_corresponding":true}],"reference_count":11,"raw_metadata":null,"created_at":"2026-07-19T00:31:05.260069Z","pmid":"35139147","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}