System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University.
Kanazawa Municipal Hospital.
Circ J. 2018 Oct 25;82(11):2852-2860. doi: 10.1253/circj.CJ-18-0237. Epub 2018 Sep 7.
Obstructive sleep apnea syndrome (OSAS) is associated with augmented sympathetic nerve activity and cardiovascular diseases. However, the interaction between coronary artery plaque characteristics and sympathetic nerve activity remains unclear. The purpose of this study was to clarify the relationships between coronary artery plaque characteristics, sleep parameters and single- and multi-unit muscle sympathetic nerve activity (MSNA) in OSAS patients.
A total of 32 OSAS patients who underwent full-polysomnography participated in this study. The coronary plaque volume was calculated with 320-slice coronary computed tomography (CT). Single- and multi-unit MSNA were obtained during the daytime within 1 week from full-polysomnography. Patients were divided into 2 groups according to their apnea-hypopnea index (AHI) score (mild-moderate group, AHI <30; and severe group, AHI ≥30). There were no group differences in risk factors for atherosclerosis; however, severe AHI patients showed significantly high single-unit MSNA, and low- and intermediate-attenuation plaque volumes. In regression analysis, the plaque volume of any CT value was not associated with single- or multi-unit MSNA; only AHI significantly correlated with low-attenuation plaque volume (R=0.52, P<0.05).
Our findings provided the evidence that AHI is an independent predictor for low-attenuated, vulnerable plaque volume, but not daytime MSNA, in patients with OSAS.
阻塞性睡眠呼吸暂停综合征(OSAS)与交感神经活动增强和心血管疾病有关。然而,冠状动脉斑块特征与交感神经活动之间的相互关系尚不清楚。本研究旨在阐明 OSAS 患者冠状动脉斑块特征、睡眠参数与单和多单位肌交感神经活动(MSNA)之间的关系。
共有 32 名接受全睡眠多导图检查的 OSAS 患者参与了本研究。采用 320 层冠状动脉计算机断层扫描(CT)计算冠状动脉斑块体积。在全睡眠多导图检查后 1 周内的白天,获得单和多单位 MSNA。根据呼吸暂停低通气指数(AHI)评分将患者分为 2 组(轻度-中度组,AHI <30;重度组,AHI ≥30)。两组在动脉粥样硬化的危险因素方面没有差异;然而,重度 AHI 患者的单单位 MSNA 显著升高,且低和中衰减斑块体积减少。在回归分析中,任何 CT 值的斑块体积均与单或多单位 MSNA 无关;仅 AHI 与低衰减斑块体积显著相关(R=0.52,P<0.05)。
我们的研究结果提供了证据,表明 AHI 是 OSAS 患者低衰减、易损斑块体积的独立预测因子,而不是日间 MSNA。