Lu Mi, Yu Wei, Wang Zhenjia, Huang Zhigang
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China.
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Brain Sci. 2022 Oct 8;12(10):1362. doi: 10.3390/brainsci12101362.
(1) Aim: We aim to evaluate the association between arousals during sleep and subclinical coronary atherosclerosis detected by coronary computed tomography angiography (CTA) in patients with obstructive sleep apnea (OSA). (2) Methods: This was a cross-sectional study. Consecutive newly diagnosed OSA patients, who underwent coronary CTA examinations within 3 months of the sleep study, were eligible. We used the arousal index (ArI) derived from polysomnography to assess arousals during sleep and a semi-automated plaque quantification software to characterize and quantify the subclinical coronary atherosclerosis. Multiple regression models were used to evaluate the associations of the ArI with the coronary atherosclerotic plaque presence, volume, and composition. (3) Results: A total of 99 patients with OSA were included in the study. In the multivariable models, patients with a high ArI (ArI > 32.2 events/h) were more likely to have coronary plaques compared to those with a low ArI (ArI ≤ 32.2 events/h) (OR: 3.29 [95% CI: 1.284 to 8.427], p = 0.013). Furthermore, the ArI exhibited significant associations with total (β = 0.015), noncalcified (β = 0.015), and low-attenuation (β = 0.012) coronary plaque volume after accounting for established risk factors (p = 0.008, 0.004, and 0.002, respectively). However, no association between the ArI and calcified plaque volume was found. (4) Conclusion: Repetitive arousals during sleep are associated with an increased coronary plaque burden in patients with OSA, which remained robust after adjusting for multiple established cardiovascular risk factors.
（1）目的：我们旨在评估阻塞性睡眠呼吸暂停（OSA）患者睡眠期间的觉醒与冠状动脉计算机断层扫描血管造影（CTA）检测到的亚临床冠状动脉粥样硬化之间的关联。（2）方法：这是一项横断面研究。连续的新诊断OSA患者，在睡眠研究后3个月内接受冠状动脉CTA检查者符合条件。我们使用多导睡眠图得出的觉醒指数（ArI）来评估睡眠期间的觉醒，并使用半自动斑块定量软件来表征和量化亚临床冠状动脉粥样硬化。使用多元回归模型来评估ArI与冠状动脉粥样硬化斑块的存在、体积和成分之间的关联。（3）结果：共纳入99例OSA患者。在多变量模型中，与低ArI（ArI≤32.2次/小时）的患者相比，高ArI（ArI>32.2次/小时）的患者更有可能有冠状动脉斑块（OR：3.29 [95%CI：1.284至8.427]，p = 0.013）。此外，在考虑了既定风险因素后，ArI与总冠状动脉斑块体积（β = 0.015）、非钙化斑块体积（β = 0.015）和低衰减斑块体积（β = 0.012）均呈显著关联（p分别为0.008、0.004和0.002）。然而，未发现ArI与钙化斑块体积之间存在关联。（4）结论：睡眠期间的反复觉醒与OSA患者冠状动脉斑块负担增加有关，在调整多个既定心血管风险因素后，这种关联仍然显著。
