Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia.
Sleep Med Rev. 2013 Feb;17(1):7-18. doi: 10.1016/j.smrv.2012.03.002. Epub 2012 Jun 1.
Large elastic arteries and smaller muscular conduit arteries become stiffer with ageing, a process that is accelerated in the presence of cardiovascular disease (CVD). In recent years, numerous techniques have been developed to measure arterial stiffness, either in single vessels or in entire muscular arterial trees. These techniques have increasingly been shown to improve stratification of cardiovascular risk and risk reduction beyond that provided by conventional risk factors. Obstructive sleep apnoea (OSA) has been increasingly linked with excess cardiovascular morbidity and mortality however the mechanisms are still not well understood. Robustly designed studies have shown that treatment of OSA with nasal continuous positive airway pressure improves important intermediate risk factors for CVD including hypertension and endothelial function. More recently, there has been increased exploration of arterial stiffness in both cross-sectional and interventional studies in OSA patients. This review aims to give the reader a better understanding of the measurement and pathophysiology of arterial stiffness as well as providing an indication of how well a prognostic indicator are the various measures of arterial stiffness for hard cardiovascular endpoints. A critical appraisal is then provided of cross-sectional and interventional studies that have explored these same techniques in OSA populations.
大动脉和较小的肌性导引导管随着年龄的增长而变得僵硬，这一过程在心血管疾病（CVD）存在的情况下会加速。近年来，已经开发出许多技术来测量动脉僵硬，无论是在单个血管还是整个肌性动脉树上。这些技术已越来越多地被证明可以改善心血管风险的分层，并在传统危险因素提供的基础上进一步降低风险。阻塞性睡眠呼吸暂停（OSA）与心血管发病率和死亡率过高越来越相关，但机制仍不清楚。设计严谨的研究表明，用持续气道正压通气治疗 OSA 可改善 CVD 的重要中间危险因素，包括高血压和内皮功能。最近，在 OSA 患者的横断面和介入研究中，对动脉僵硬的研究也有所增加。这篇综述旨在使读者更好地了解动脉僵硬的测量和病理生理学，并提供各种动脉僵硬测量指标对硬心血管终点的预后价值的指示。然后对探讨 OSA 人群中这些相同技术的横断面和介入研究进行了批判性评估。
