Ascending aorta dilatation indicates obstructive sleep apnea in Chinese patients with cardiovascular disease.

Purpose: Obstructive sleep apnea (OSA) is prevalent in patients with cardiovascular disease (CVD), and is linked to worsened outcomes. Screening tools are essential for early detection and intervention. We aimed to investigate the role of ascending aorta diameter (AAD) obtained from echocardiography in identifying OSA in CVD patients.

Methods: We examined the correlation between AAD and sleep apnea test parameters in 721 hospitalized CVD (including hypertension, coronary artery disease, chronic heart failure, atrial fibrillation, and pulmonary hypertension) patients. Multivariate analyses were performed on all findings. Receiver operator characteristic curve (ROC) analyses were used to determine the role of AAD in detecting OSA.

Results: AAD was significantly higher in patients with OSA than those without OSA. AAD significantly correlated with apnea-hypopnea index (AHI) and saturation-related parameters. In comparison, pulmonary artery diameter did not correlate with AHI but had significant negative correlations with the saturation-related parameters. The area under the ROC of AAD for detecting OSA in CVD patients was 0.70 (95% CI, 0.65-0.74; p < 0.001). In the chronic heart failure subgroup, the area under the curve for AAD was 0.75 (95% CI 0.67-0.82, p < 0.001). The optimal cut-off value of AAD was 31.5 mm, resulting in a sensitivity of 73%, a specificity of 55% in CVD patients, and 29.5 mm with a sensitivity of 82% and a specificity of 64% in chronic heart failure patients.

Conclusions: AAD was associated with the severity of OSA. AAD could be a valuable tool for identifying OSA in CVD patients, particularly in patients with chronic heart failure.