Obstructive Sleep Apnea Syndrome: Blood Viscosity, Blood Coagulation Abnormalities, and Early Atherosclerosis

Toraldo, Domenico Maurizio; Peverini, F; Benedetto, Michele De; Nuccio, Francesco De

doi:10.1007/s00408-012-9427-3

Cited by 41 publications

(41 citation statements)

References 45 publications

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“…Atherosclerosis is common in OSAS, and several studies have demonstrated that the elevated mortality in OSAS is associated with the severity of the atherosclerosis [33]. In OSAS subjects the carotid intima-media thickness is significantly increased compared to controls [22] and a recent study has demonstrated that OSAS severity is correlated also with subclinical coronary atherosclerosis [38].…”

Section: Introductionmentioning

confidence: 99%

Gelatinases and their tissue inhibitors in a group of subjects with obstructive sleep apnea syndrome

Hopps¹,

Canino²,

Montana

et al. 2016

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Abstract. Obstructive sleep apnea syndrome (OSAS) is associated with an elevated risk of cardiovascular events and stroke. Matrix metalloproteinases (MMPs) are endopeptidases involved in extracellular matrix degradation and then in the development and progression of cardiovascular diseases. Our aim was to evaluate plasma levels of gelatinases (MMP-2 and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2) in a group of subjects with OSAS. We enrolled 48 subjects (36 men and 12 women; mean age 49.7 ± 14.68 yrs) with OSAS diagnosed with a 1-night cardiorespiratory study and then we subdivided these subjects into two subgroups according to the apnea/hypopnea index (AHI): Low (L = 21 subjects with AHI <30) and High (H = 27 subjects with AHI >30). We measured plasma concentration of the gelatinases and their inhibitors using ELISA kits. We observed a significant increase in plasma concentration of MMP-9, MMP-2, TIMP-1 and TIMP-2 in the entire group of OSAS subjects and in the two subgroups, with higher levels in the H in comparison with the L subgroup. In the whole group of OSAS subjects we also noted a significant decrease in MMP-9/TIMP-1 ratio in comparison with normal controls. Only MMP-9 was significantly correlated with the severity of the disease, expressed as AHI, with the oxygen desaturation index and also with the mean oxygen saturation. MMPs pattern is altered in OSAS and significantly influenced by the severity of the disease; it probably contributes to the vascular remodeling that leads to the atherosclerotic disease and cardiovascular complications.

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Section: Introductionmentioning

confidence: 99%

Gelatinases and their tissue inhibitors in a group of subjects with obstructive sleep apnea syndrome

Hopps¹,

Canino²,

Montana

et al. 2016

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Section: Descriptionmentioning

confidence: 66%

“…COX-1 inhibition reduced lesion progression in intermittent hypoxia mice. This study has demonstrated, for the first time, that the activation of the COX pathway exposed to CIH is associated with increased atherosclerotic lesions in mice, highlighting early atherosclerosis markers in OSA patients [1,2].CIH and sleep disruption are responsible of pathophysiological pathways determining a systemic disease. In fact, OSA has been associated with diseases with a high inflammatory potential, such as psoriasis and other autoimmune disorders.…”

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confidence: 70%

Obstructive Sleep Apnea Syndrome (OSA) and Cancer: Current Insights

Toraldo¹

2015

J Sleep Disord Ther

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DescriptionThe obstructive sleep apnea syndrome (OSA) is an independent risk factor for atherosclerosis. Chronic intermittent hypoxia (CHI) causes atherosclerosis in the occurrence of a pre-existing hyperlipidemia. A new pathway, in animal models, has been demonstrated that CIH significantly increased atherosclerotic lesion sizes, mRNA levels of COX-1 and thromboxane synthase (TXBS). Lesion size is correlated to COX-1 and TXBS mRNA levels. COX-1 inhibition reduced lesion progression in intermittent hypoxia mice. This study has demonstrated, for the first time, that the activation of the COX pathway exposed to CIH is associated with increased atherosclerotic lesions in mice, highlighting early atherosclerosis markers in OSA patients [1,2].CIH and sleep disruption are responsible of pathophysiological pathways determining a systemic disease. In fact, OSA has been associated with diseases with a high inflammatory potential, such as psoriasis and other autoimmune disorders. The potential mechanisms involved in the cancer development progression from hypoxia have been investigated. It has been shown, that CIH can regulate different stages of cell differentiation and proliferation in animal models. The cellular hypoxia, present in cancer, and the adaptive response is geared to a family of transcription factors, the most significant being hypoxiainducible factor (HIF)-1.HIF-1 activates the transcription of genes which play a fundamental role in angiogenesis and genetic modification, with the formation of cancer-related stem cells. The prevalence of HIF-1 has been associated with a considerable increase in reactive oxygen species (ROS) generated during periods of hypoxia/reoxygenation, which may play an important role in modifying gene expression by regulating the activity of some transcription factors. These include activator protein-1, which may play a key role in carcinogenesis, with the development of cancer through the induction of apoptotic inhibitory factors, matrix metallo-proteases and pro-angiogenic factors of which the most important is probably vascular endothelial growth factor (VEGF) [3].

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“…41 In addition, research has emphasized that thrombotic tendency and blood viscosity are possible mechanisms of disease in subjects with OSA and cardiovascular comorbidity. 2 …”

Section: Possible Mechanism Of Cpap On Blood Pressurementioning

confidence: 99%

“…1 It is known that OSA is a considerable risk factor for both cardiovascular and cerebrovascular diseases. 2 CPAP treatment is the standard for managing OSA and has been proven to reduce the apnea-hypopnea index (AHI), improve sleep quality in subjects with OSA, 3 and decrease the risk for cardiovascular comorbidities. 4 An increase in blood pressure has a high correlation with OSA, and CPAP lowers the mortality rate in subjects with severe OSA.…”

Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Long-Term CPAP Treatment on Sleep Quality and Blood Pressure in Adherent Subjects With Obstructive Sleep Apnea

et al. 2015

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BACKGROUND: Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular diseases. Although CPAP is the first treatment choice for moderate-to-severe OSA, acceptance of and adherence to CPAP remain problematic. High CPAP adherence is generally defined as >4 h of use/night for >70% of the nights monitored. We investigated the long-term beneficial effects of CPAP on sleep quality and blood pressure in subjects with moderate-to-severe OSA according to high or low CPAP adherence. METHODS: We retrospectively analyzed 121 subjects with moderate-to-severe OSA from August 2008 to July 2012. These subjects were divided into 3 groups: (1) no CPAP treatment (n ‫؍‬ 29), (2) low CPAP adherence (n ‫؍‬ 28), and (3) high CPAP adherence (n ‫؍‬ 64). All subjects were followed up for at least 1 y. The 3 groups were compared regarding anthropometric and polysomnographic variables, presence of cardiovascular comorbidities, and blood pressure at baseline and at the last follow-up. RESULTS: The no-treatment group showed significant increases in oxygen desaturation index and blood pressure. The high-adherence group showed significant improvement in daytime sleepiness, apnea-hypopnea index (AHI), oxygen desaturation index, and blood pressure. Although the AHI was also significantly decreased after CPAP treatment in the lowadherence group, blood pressure remained unchanged. CONCLUSIONS: CPAP treatment had beneficial effects on both sleep quality and blood pressure only in subjects with OSA and high CPAP adherence who used CPAP for >4 h/night for >70% of nights monitored. Subjects with low CPAP adherence received beneficial effects on AHI, but not blood pressure.

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Obstructive Sleep Apnea Syndrome: Blood Viscosity, Blood Coagulation Abnormalities, and Early Atherosclerosis

Cited by 41 publications

References 45 publications

Gelatinases and their tissue inhibitors in a group of subjects with obstructive sleep apnea syndrome

Gelatinases and their tissue inhibitors in a group of subjects with obstructive sleep apnea syndrome

Obstructive Sleep Apnea Syndrome (OSA) and Cancer: Current Insights

Beneficial Effects of Long-Term CPAP Treatment on Sleep Quality and Blood Pressure in Adherent Subjects With Obstructive Sleep Apnea

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