Association of Obstructive Sleep Apnea with Peripheral Endothelial Function Assessed by Reactive Hyperemia Index
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Background: Obstructive sleep apnea (OSA) has been shown to be an important risk factor for metabolic syndrome andcardiovascular disease. Endothelial dysfunction plays a pivotal role in the pathophysiology of these diseases. However, littleis known about the relationship between sleep apnea and microvascular endothelial dysfunction, as assessed by digitalreactive hyperemia. Methods: The study population consisted of 80 patients (mean age, 48 ± 12 years-old; 65 men; 59hypertensive). We measured apnea–hypopnea index (AHI) and mild OSA was defined as 5 < AHI <15 and moderate tosevere OSA as AHI ≥ 15. Reactive hyperemia index (RHI) derived from peripheral arterial tonometry (PAT) asmeasurement of endothelium-mediated vasodilatation. Results: There were 61 OSA patients in the study population (AHI,21.5 ± 16.7 vs. 2.7 ± 1.6 in non-OSA; p < 0.001). There were no significant difference in RHI and peripheral augmentation index(pAIx) between OSA and non-OSA group (RHI, 2.04 ± 0.48 vs. 2.06 ± 0.42; p = 0.894; pAIx, 21.7% ± 24.0% vs. 21.7% ±30.0%; p = 1.000, respectively). Also, there was no significant difference in RHI and pAIx between mild (n = 31) andmoderate to severe (n = 30) OSA group (RHI, 2.10 ± 0.47 vs. 1.98 ± 0.49; p = 0.333; pAIx, 24.2% ± 20.7% vs. 19.0% ± 27.2%;p = 0.407, respectively), either. Overall, no significant correlation between AHI and RHI was observed (r = -0.023, p = 0.837). The other OSA severity indices such as oxygen desaturation index, mean and minimum oxygen saturation were not correlatedwith RHI or pAIx. In the subgroup analysis for the OSA group, we could not find any significant relationships between AHIand PAT parameters, either. Conclusions: OSA was not observed to be associated with reactive hyperemia measured by PAT.
Abstract
Background: Obstructive sleep apnea (OSA) has been shown to be an important risk factor for metabolic syndrome andcardiovascular disease. Endothelial dysfunction plays a pivotal role in the pathophysiology of these diseases. However, littleis known about the relationship between sleep apnea and microvascular endothelial dysfunction, as assessed by digitalreactive hyperemia. Methods: The study population consisted of 80 patients (mean age, 48 ± 12 years-old; 65 men; 59hypertensive). We measured apnea–hypopnea index (AHI) and mild OSA was defined as 5 < AHI <15 and moderate tosevere OSA as AHI ≥ 15. Reactive hyperemia index (RHI) derived from peripheral arterial tonometry (PAT) asmeasurement of endothelium-mediated vasodilatation. Results: There were 61 OSA patients in the study population (AHI,21.5 ± 16.7 vs. 2.7 ± 1.6 in non-OSA; p < 0.001). There were no significant difference in RHI and peripheral augmentation index(pAIx) between OSA and non-OSA group (RHI, 2.04 ± 0.48 vs. 2.06 ± 0.42; p = 0.894; pAIx, 21.7% ± 24.0% vs. 21.7% ±30.0%; p = 1.000, respectively). Also, there was no significant difference in RHI and pAIx between mild (n = 31) andmoderate to severe (n = 30) OSA group (RHI, 2.10 ± 0.47 vs. 1.98 ± 0.49; p = 0.333; pAIx, 24.2% ± 20.7% vs. 19.0% ± 27.2%;p = 0.407, respectively), either. Overall, no significant correlation between AHI and RHI was observed (r = -0.023, p = 0.837). The other OSA severity indices such as oxygen desaturation index, mean and minimum oxygen saturation were not correlatedwith RHI or pAIx. In the subgroup analysis for the OSA group, we could not find any significant relationships between AHIand PAT parameters, either. Conclusions: OSA was not observed to be associated with reactive hyperemia measured by PAT.
참고문헌 (23)
- Young T, "Epidemiology of obstructive sleep apnea: a population health perspective", Am J Respir Crit Care Med, 165, pp.1217~1239 (2002)
- Somers VK, "Sleep apnea and cardiovascular disease: an American Heart Association", american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research, 2008, pp.118, 1080~1111[DOI]
- Baguet JP, "Mechanisms of cardiac dysfunction in obstructive sleep apnea", Nat Rev Cardiol, 9, pp.679~688 (2012)
- Yaggi HK, "Obstructive sleep apnea as a risk factor for stroke and death", N Engl J Med, 353, pp.2034~2041 (2005)
- Gami AS, "Association of atrial fibrillation and obstructive sleep apnea", Circulation, 110, pp.364~367 (2004)
- Budhiraja R, "Endothelial dysfunction in obstructive sleep apnea", J Clin Sleep Med, 3, pp.409~415 (2007)
- Namtvedt SK, "Impaired endothelial function in persons with obstructive sleep apnoea : impact of obesity", Heart, 99, pp.30~34 (2013)
- Kato M, "Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea", Circulation, 102, pp.2607~2610 (2000)
- Oflaz H, "Endothelial function in patients with obstructive sleep apnea syndrome but without hypertension", Respiration, 73, pp.751~756 (2006)
- Chung S, "The association of nocturnal hypoxemia with arterial stiffness and endothelial dysfunction in male patients with obstructive sleep apnea syndrome", Respiration, 79, pp.363~369 (2010)
- Chami HA, "Brachial artery diameter, blood flow and flow-mediated dilation in sleep-disordered breathing", Vasc Med, 14, pp.351~360 (2009)
- Kuvin JT, "Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude", Am Heart J, 146, pp.168~174 (2003)
- Yang WI, "Augmentation index association with reactive hyperemia as assessed by peripheral arterial tonometry in hypertension", Am J Hypertens, 24, pp.1234~1238 (2011)
- Hamburg NM, "Cross-sectional relations of digital vascular function to cardiovascular risk factors in the Framingham Heart Study", Circulation, 117, pp.2467~2474 (2008)
- Rubinshtein R, "Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events", Eur Heart J, 31, pp.1142~1148 (2010)
- Hamburg NM, "Relation of brachial and digital measures of vascular function in the community : the Framingham heart study", Hypertension, 57, pp.390~396 (2011)
- Patil SP., "What every clinician should know about polysomnography", Respir Care, 55, pp.1179~1195 (2010)
- Grigg-Damberger MM., "The AASM Scoring Manual four years later", J Clin Sleep Med, 8, pp.323~332 (2012)
- Drager LF, "Obstructive sleep apnea : a cardiometabolic risk in obesity and the metabolic syndrome", J Am Coll Cardiol, 62, pp.569~576 (2013)
- Seif F, "Association between obstructive sleep apnea severity and endothelial dysfunction in an increased background of cardiovascular burden", J Sleep Res, 22, pp.443~451 (2013)
- Heffernan KS, "Peripheral augmentation index as a biomarker of vascular aging : an invasive hemodynamics approach", Eur J Appl Physiol, 112, pp.2871~2879 (2012)
- Morris AA, "Racial differences in arterial stiffness and microcirculatory function between Black and White Americans", J Am Heart Assoc, 2, pp.e002154~ (2013)
- Butt M, "Myocardial perfusion by myocardial contrast echocardiography and endothelial dysfunction in obstructive sleep apnea", Hypertension, 58, pp.417~424 (2011)