Çörtük Mustafa, Akyol Selahattin, Baykan Ahmet O, Kiraz Kemal, Uçar Hakan, Çaylı Murat, Kandiş Hayati
Department of Pulmonology Medicine, Karabük University Medical Faculty, Karabük, Turkey.
Department of Cardiology, Adana Training and Research Hospital, Adana, Turkey.
Clin Respir J. 2016 Jul;10(4):455-61. doi: 10.1111/crj.12244. Epub 2014 Dec 23.
Obstructive sleep apnoea syndrome (OSA) and aortic stiffness are associated with an increased risk of cardiovascular morbidity and mortality. Although aortic stiffness increased in patients with OSA, the relationship between severity of OSA indicated with apnoea-hypopnea index (AHI) and aortic stiffness was not investigated in previous studies. The aim of this study is to investigate the relationship between the severity of OSA and aortic stiffness.
In the present study, 90 consecutive OSA patients definite diagnosed with sleep test were prospectively included (mean age 54.5 ± 11.6 years). Aortic pulse wave velocity (PWV) and augmentation index (AIx) were calculated using the single-point method via the Mobil-O-Graph® ARCsolver algorithm. Aortic distensibility (AD) was calculated from the echocardiographically derived ascending aorta diameters and haemodynamic pressure measurements. Overnight full-laboratory polysomnography examination was conducted on each subject. Patients were classified into two groups according to their median AHI values (AHIlow and AHIhigh groups).
PWV values were higher and AD values were lower in AHIhigh group compared with AHIlow group (P < 0.05, for all). AHI was associated with body mass index (BMI), systolic blood pressure, pulse pressure, aortic diameter, AD, AIx and PWV in bivariate analysis (P < 0.05, for all). Multivariate linear regression analysis showed that AHI was independently associated with BMI (β = 0.175, P = 0.047), PWV (β = 0.521, P < 0.001) and aortic distensibility (β = -0.223, P = 0.020).
Aortic stiffness is associated both with the presence and the severity of OSA.
阻塞性睡眠呼吸暂停综合征（OSA）与主动脉僵硬度增加均与心血管疾病发病率和死亡率升高相关。尽管OSA患者的主动脉僵硬度会增加，但既往研究未探讨以呼吸暂停低通气指数（AHI）表示的OSA严重程度与主动脉僵硬度之间的关系。本研究旨在探讨OSA严重程度与主动脉僵硬度之间的关系。
在本研究中，前瞻性纳入了90例经睡眠测试明确诊断的连续性OSA患者（平均年龄54.5±11.6岁）。通过Mobil-O-Graph® ARCsolver算法采用单点法计算主动脉脉搏波速度（PWV）和增强指数（AIx）。根据超声心动图得出的升主动脉直径和血流动力学压力测量值计算主动脉扩张性（AD）。对每位受试者进行整夜全实验室多导睡眠图检查。根据患者的AHI中位数将其分为两组（AHI低组和AHI高组）。
与AHI低组相比，AHI高组的PWV值更高，AD值更低（所有P<0.05）。在双变量分析中，AHI与体重指数（BMI）、收缩压、脉压、主动脉直径、AD、AIx和PWV相关（所有P<0.05）。多变量线性回归分析显示，AHI与BMI（β=0.175，P=0.047）、PWV（β=0.521，P<0.001）和主动脉扩张性（β=-0.223，P=0.020）独立相关。
主动脉僵硬度与OSA的存在及其严重程度均相关。
