Intima-Media Thickness in Patients With Obstructive Sleep Apnea Without Comorbidities

Abstract

BackgroundObstructive sleep apnea (OSA) is associated with elevated risk of cardiovascular events. The early stages of vascular complications can be visualized by means of ultrasound. Intima-media thickness (IMT) correlates with the presence of risk factors of cardiovascular diseases such as hypertension, diabetes, tobacco smoking, or hyperlipidemia. However, little is known whether OSA itself may be the cause of IMT thickening.MethodsThe study group was composed of 28 patients (6 women, 22 men; mean age = 53.8 years, mean BMI = 27.1 kg/m2, mean AHI = 22.4/h) with OSA who had no comorbidities. The control group consisted of 28 healthy subjects (6 women, 22 men; mean age = 53.9 years; mean BMI = 27.5 kg/m2). In both groups IMT was assessed in common carotid arteries with the use of ultrasonography. Additionally, in patients with OSA, pulse wave velocity, echocardiography, 24-h automated blood pressure monitoring, clinical signs and symptoms, and blood tests were performed to investigate possible correlations with IMT.ResultsMedian IMT was 0.41 mm in OSA patients and 0.46 mm in the control group (p = 0.087). Echocardiography revealed left ventricle hypertrophy in 21 %, systolic disorders in 8 %, and diastolic disorders in 57 % of the patients. In a large majority of patients, pulse wave velocity was found to be normal. IMT correlated with age (r = 0.446, p = 0.017), total cholesterol (r = 0.518, p = 0.005), daytime systolic blood pressure (r = 0.422, p = 0.025), pulse pressure 24 h and daytime (r = 0.424, p = 0.027 and r = 0.449, p = 0.019), early mitral flow/atrial mitral flow (E/A) (r = −0.429, p = 0.023), and posterior wall diameter (PWD) (r = 0.417, p = 0.270).ConclusionIn a relatively nonobese group of patients, no significant differences were found in the intima-media thickness between OSA patients without concomitant cardiovascular diseases and healthy controls. This may lead to the conclusion that IMT does not reflect increased risk of cardiovascular events in patients with isolated OSA.

Association of Adipocytokines With Carotid Intima Media Thickness and Arterial Stiffness in Obstructive Sleep Apnea Patients

“…Previous research indicates that quantitative IMT and QAS techniques, as noninvasive examinations, provides a comprehensive evaluation of CCA remodeling for assessing preclinical atherosclerosis and early-stage diabetes (15,16,30). Although several studies have shown that there are no changes in carotid IMT in OSA patients compared to non-snorers (13,31), substantial evidence indicates a significant increase in OSA patients compared to non-snorers (32). In this study, we creatively used the ultrasound radiofrequency technology to detect changes in the structure and function of the carotid artery in OSA patients.…”

“…It has also been suggested that the values of arterial stiffness and compliance [pulse wave velocity (PWV) and carotid distensibility coefficient (DC)] are useful indices for predicting the future risk of cardiovascular events such as stroke and coronary heart disease (9,10). Increased IMT in OSA patients has been widely demonstrated (11)(12)(13)(14). Innovations in ultrasound technology, such as the US radiofrequency (RF)-data technology, allow for an automatic and accurate measurement of carotid IMT and arterial elasticity.…”

Carotid Artery Wall Thickness in Obese and Nonobese Adults With Obstructive Sleep Apnea Before and Following Positive Airway Pressure Treatment

“…These results are consistent with some previous studies. Gorzewska et al 29 studied 28 nonobese OSA patients with no history of cardiovascular disease or significant abnormalities in glucose, hemoglobin A1c, and lipids. No significant differences were reported in carotid IMT between OSA cases and controls, and there were no associations between IMT versus AHI and the level of oxygen desaturation.…”

Impact of inflammation and oxidative stress on carotid intima‐media thickness in obstructive sleep apnea patients without metabolic syndrome

“…Carotid intima‐media thickness (IMT) is a good indicator of the severity of atherosclerotic disease (O'Leary et al ., ) and can be a useful marker for the early stage of atherosclerosis (O'Leary and Polak, ). For research on risk factors for increased IMT in patients with OSA (Baguet et al ., ; Ciccone et al ., ; Gorzewska et al ., ; Kostrzewska et al ., ; Minoguchi et al ., ; Silvestrini et al ., ; Suzuki et al ., ), most previous studies had relatively small numbers of patients (Drager et al ., ; Gorzewska et al ., ; Minoguchi et al ., ) and less strict selection, and included patients lacking a polysomnography (PSG) diagnosis and those with several underlying diseases (Thunstrom et al ., ).…”