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Early Signs of Atherosclerosis in Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is associated with several cardiovascular diseases. However, the mechanisms are not completely understood. Recent studies have shown that OSA is associated with multiple markers of endothelial damage. We hypothesized that OSA affects functional and structural properties...

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Published in:American journal of respiratory and critical care medicine 2005-09, Vol.172 (5), p.613-618
Main Authors: Drager, Luciano F, Bortolotto, Luiz A, Lorenzi, Maria Cecilia, Figueiredo, Adelaide C, Krieger, Eduardo M, Lorenzi-Filho, Geraldo
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description Obstructive sleep apnea (OSA) is associated with several cardiovascular diseases. However, the mechanisms are not completely understood. Recent studies have shown that OSA is associated with multiple markers of endothelial damage. We hypothesized that OSA affects functional and structural properties of large arteries, contributing to atherosclerosis progression. Twelve healthy volunteers, 15 patients with mild to moderate OSA, and 15 with severe OSA matched for age, sex, and body mass index were studied by using (1) full standard overnight polysomnography; (2) carotid-femoral pulse wave velocity with a noninvasive automatic device; and (3) a high-definition echo-tracking device to measure intima-media thickness, diameter, and distensibility. All participants were free of hypertension, diabetes, and smoking, and were not on any medications. Patients with OSA were naive to treatment. Significant differences existed between control subjects and patients with mild to moderate and severe OSA (apnea-hypopnea index, 3.1 +/- 0.3, 16.2 +/- 1.7, and 55.7 +/- 5.9 events/hour, respectively) in pulse wave velocity (8.7 +/- 0.2, 9.2 +/- 0.2, and 10.3 +/- 0.2 m/second; p < 0.0001), intima-media thickness (604.4 +/- 25.2, 580.2 +/- 29.0, and 722.2 +/- 35.2 microm; p = 0.004), and carotid diameter (6,607.8 +/- 126.7, 7,152.3 +/- 114.4, and 7,539.9 +/- 161.2 microm; p < 0.0001). Multivariate analyses showed that the apnea-hypopnea index correlated independently with pulse wave velocity and intima-media thickness variability (r = 0.61, p < 0.0001, and r = 0.44, p = 0.004, respectively), whereas minimal oxygen saturation correlated with the carotid diameter (r = -0.60, p < 0.0001). Middle-aged patients with OSA who are free of overt cardiovascular diseases have early signs of atherosclerosis. All vascular abnormalities correlated significantly with the severity of the OSA, which further supports the hypothesis that OSA plays an independent role in atherosclerosis progression.
doi_str_mv 10.1164/rccm.200503-340OC
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However, the mechanisms are not completely understood. Recent studies have shown that OSA is associated with multiple markers of endothelial damage. We hypothesized that OSA affects functional and structural properties of large arteries, contributing to atherosclerosis progression. Twelve healthy volunteers, 15 patients with mild to moderate OSA, and 15 with severe OSA matched for age, sex, and body mass index were studied by using (1) full standard overnight polysomnography; (2) carotid-femoral pulse wave velocity with a noninvasive automatic device; and (3) a high-definition echo-tracking device to measure intima-media thickness, diameter, and distensibility. All participants were free of hypertension, diabetes, and smoking, and were not on any medications. Patients with OSA were naive to treatment. Significant differences existed between control subjects and patients with mild to moderate and severe OSA (apnea-hypopnea index, 3.1 +/- 0.3, 16.2 +/- 1.7, and 55.7 +/- 5.9 events/hour, respectively) in pulse wave velocity (8.7 +/- 0.2, 9.2 +/- 0.2, and 10.3 +/- 0.2 m/second; p &lt; 0.0001), intima-media thickness (604.4 +/- 25.2, 580.2 +/- 29.0, and 722.2 +/- 35.2 microm; p = 0.004), and carotid diameter (6,607.8 +/- 126.7, 7,152.3 +/- 114.4, and 7,539.9 +/- 161.2 microm; p &lt; 0.0001). Multivariate analyses showed that the apnea-hypopnea index correlated independently with pulse wave velocity and intima-media thickness variability (r = 0.61, p &lt; 0.0001, and r = 0.44, p = 0.004, respectively), whereas minimal oxygen saturation correlated with the carotid diameter (r = -0.60, p &lt; 0.0001). Middle-aged patients with OSA who are free of overt cardiovascular diseases have early signs of atherosclerosis. All vascular abnormalities correlated significantly with the severity of the OSA, which further supports the hypothesis that OSA plays an independent role in atherosclerosis progression.</abstract><cop>New York, NY</cop><pub>Am Thoracic Soc</pub><pmid>15901608</pmid><doi>10.1164/rccm.200503-340OC</doi><tpages>6</tpages></addata></record>
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subjects Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Arteriosclerosis - diagnostic imaging
Arteriosclerosis - etiology
Atherosclerosis
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Blood Flow Velocity
Body mass index
Cardiology. Vascular system
Cardiovascular disease
Carotid arteries
Carotid Arteries - diagnostic imaging
Chronic obstructive pulmonary disease, asthma
Coronary vessels
Diabetes
Disease Progression
Female
Humans
Hypertension
Hypotheses
Intensive care medicine
Male
Medical equipment
Medical sciences
Middle Aged
Oxygen saturation
Pneumology
Polysomnography
Pulse
Sleep apnea
Sleep Apnea, Obstructive - complications
Sleep Apnea, Obstructive - diagnosis
Tunica Intima - diagnostic imaging
Tunica Media - diagnostic imaging
Ultrasonography
Vein & artery diseases
Velocity
title Early Signs of Atherosclerosis in Obstructive Sleep Apnea
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