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阻塞性睡眠呼吸暂停患者的冠状动脉斑块综合评估。

Comprehensive coronary plaque assessment in patients with obstructive sleep apnea.

机构信息

Department of Pulmonology, Semmelweis University, Budapest, Hungary.

Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.

出版信息

J Sleep Res. 2019 Oct;28(5):e12828. doi: 10.1111/jsr.12828. Epub 2019 Feb 6.

Abstract

Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease. Previous studies have assessed the relationship between OSA and coronary artery disease (CAD) using coronary artery calcium score (CAC) measurements. However, limited data are available regarding the association of OSA with non-calcified plaque burden. We therefore aimed to assess the relationship between CAD severity as assessed by coronary computed tomography angiography (CTA) and OSA. Forty-one adult subjects (59 ± 9 years, 15 men) underwent a 256-slice coronary CTA, which was followed by a diagnostic attended cardiorespiratory polygraphy (n = 13) or polysomnography (n = 28). Segment involvement score (SIS), segment stenosis score (SSS) and CAC were used to quantify total CAD burden. Correlation analysis was used to assess potential associations between CAD and OSA. Twenty-two patients were diagnosed with OSA. SIS and SSS were elevated in OSA (2.90 ± 2.78 versus 1.79 ± 2.39 and 4.91 ± 5.94 versus 1.79 ± 4.54, OSA versus controls, SIS and SSS respectively, both p < 0.01) and correlated with OSA severity as measured by the apnea-hypopnea index (AHI, r = 0.41 and 0.43, p < 0.01) and oxygen desaturation index (ODI, r = 0.45 and 0.46, p < 0.01). However, no significant correlation was observed between CAC and OSA. Compared to CAC, SIS and SSS provide additional information on coronary plaque burden in OSA, which shows a significant association with OSA.

摘要

阻塞性睡眠呼吸暂停(OSA)与心血管疾病风险增加相关。先前的研究已经使用冠状动脉钙评分(CAC)测量评估了 OSA 与冠状动脉疾病(CAD)之间的关系。然而,关于 OSA 与非钙化斑块负担之间的关联,可用的数据有限。因此,我们旨在评估冠状动脉计算机断层血管造影(CTA)评估的 CAD 严重程度与 OSA 之间的关系。41 名成年受试者(59±9 岁,15 名男性)接受了 256 层冠状动脉 CTA,随后进行了诊断性睡眠呼吸暂停监测(n=13)或多导睡眠图(n=28)。节段受累评分(SIS)、节段狭窄评分(SSS)和 CAC 用于量化总 CAD 负担。相关性分析用于评估 CAD 和 OSA 之间的潜在关联。22 名患者被诊断为 OSA。OSA 患者的 SIS 和 SSS 升高(2.90±2.78 比 1.79±2.39 和 4.91±5.94 比 1.79±4.54,OSA 与对照组,SIS 和 SSS 分别,均 p<0.01),并且与通过呼吸暂停-低通气指数(AHI,r=0.41 和 0.43,p<0.01)和氧减饱和度指数(ODI,r=0.45 和 0.46,p<0.01)测量的 OSA 严重程度相关。然而,CAC 与 OSA 之间未观察到显著相关性。与 CAC 相比,SIS 和 SSS 提供了 OSA 冠状动脉斑块负担的额外信息,并且与 OSA 具有显著关联。

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