Is There Evidence of Early Vascular Disease in Patients with Obstructive Sleep Apnoea Without Known Comorbidities? Preliminary Findings

Abstract

We evaluated early atherosclerotic lesions in 20 non-smokers with newly diagnosed Obstructive Sleep Apnoea (OSA) and without known comorbidities by measuring common carotid artery intima media thickness (CCA-IMT), transcranial Doppler ultrasound (TCD), and ankle brachial index (ABI). These were compared with 20 healthy age- and BMI-matched controls. In OSA patients, CCA-IMT was not significantly higher vs. controls (0.74±0.17 vs. 0.66±0.12 mm, p=0.201) and it was positively correlated with neck circumference (r=0.466, p=0.039), arousal index (r=0.663, p=0.001), gamma-glutamyl transpeptidase activity (r=0.474, p=0.035) while it was negatively correlated with Forced Expiratory Volume in 1 sec (r=-0.055, p=0.012). No difference was noted between patients and controls in terms of vascular stenosis on TCD examination, while asymptomatic peripheral artery disease was found in one patient with OSA. In conclusion, OSA patients without known comorbidities exhibit a non-significant increase in CCA-IMT without further evidence of vascular disease, but additional experience in a larger patient series is needed.

Neck circumference and early stage atherosclerosis: the cardiometabolic risk in Chinese (CRC) study

“…It has been shown that elevated concentration of free fatty acid increased oxidative stress [[ 33 ]] and provoked vascular endothelial injury [[ 34 ]]. In addition, NC is an important predictor for obstructive sleep apnea (OSA), and OSA has been associated with arterial stiffening [[ 35 ],[ 36 ]].…”

Targeting subclinical organ damage in obstructive sleep apnea: a narrative review

“…In the OSA setting, oxidative stress combined with low-grade inflammation and sympathetic over-activity have been reported to play a key role in promoting endothelial damage and atherosclerosis, by increasing lipid peroxidation and reactive oxygen species and impairing serum antioxidant capacity. In the last two decades, numerous research groups have investigated the relationship between OSA and CIMT with not univocal results [49][50][51][52].…”

Modelos predictivos de riesgo cardiovascular

“…En cuanto al tabaquismo, el ser fumador aumenta 6 veces el riesgo en hombres y dos veces en mujeres si el consumo en promedio es de 20 cigarrillos día, adicional se ha visto como el dejar de fumar disminuye signifi cativamente el riesgo de padecer ECV (Tabla 1). Otras condiciones en el paciente diabético afectan de igual manera la evaluación, el padecer por más de 10 años DM, una tasa de fi ltración glomerular disminuida, proteinuria y microalbuminuria; en este punto no hay datos sobre reclasifi cación, discriminación, calibración o costo efecto que permitan adicionar estos últimos tres factores a los modelos actuales aunque su presencia junto a la DM incrementan el riesgo; hipertensión arterial, hiperlipidemia, padecer esteatosis hepática no alcohólica, disfunción eréctil, apnea obstructiva del sueño, hiperglucemia cróni-ca e hipoglicemia severa (20,(22)(23)(24)(25)(26).…”