Silent Brain Infarction and Platelet Activation in Obstructive Sleep Apnea

Minoguchi, Kenji; Yokoe, Takuya; Takagi, Toshiyuki; Minoguchi, Hideko; Oda, Naruhito; Tanaka, Akihiko; Yamamoto, Masayuki; Ohta, Shin; O’Donnell, Christopher P.; Adachi, Mitsuru

doi:10.1164/rccm.200608-1141oc

Cited by 197 publications

(139 citation statements)

References 41 publications

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“…84 Sleep deprivation also may trigger systemic inflammation. 85,86 The combination of repetitive hypoxemia and sleep deprivation in OSA patients may be associated with increased levels of plasma cytokines, adhesion molecules, 87,88 serum amyloid A, 89 and C-reactive protein. 88,90 -92 Although the increase in C-reactive protein in OSA appears to be independent of adiposity, 92 this question remains controversial.…”

Section: Inflammationmentioning

confidence: 99%

“…In a cross-sectional study of Japanese men, brain magnetic resonance imaging revealed silent brain infarction in 25% of patients with moderate to severe OSA but in only 8% of patients with mild OSA and in 6% of control subjects, suggesting that OSA may elicit early and asymptomatic cerebrovascular damage. 88 Available data often are limited by the use of oximetry rather than complete polysomnographic studies and by the relatively small numbers of subjects studied. Furthermore, the broad spectrum of comorbidities and pharmacological intervention in poststroke patients constrains identification of any independent premorbid etiologic role of sleep apnea.…”

Section: Osa and The Origin And Progression Of Strokementioning

confidence: 99%

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Sleep Apnea and Cardiovascular Disease

et al. 2008

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Section: Inflammationmentioning

confidence: 99%

Section: Osa and The Origin And Progression Of Strokementioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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“…But the mechanisms of Plt activation in patients with OSAS may be the chronic intermittent hypoxia and high levels of catecholamines which is a result of sympathetic activity [30][31][32]. Minogluchi et al [33] reported that the levels of sCD40L and sPselectin which were known as Plt activation markers increased in patients with moderate and severe OSAS. Hui at al.…”

Section: Discussionmentioning

confidence: 99%

Effect of Continuous Positive Airway Pressure Treatment on Hemograms of Patients with Severe Obstructive Sleep Apnea in the Lack of Comorbidities

Tapan¹,

Görgülü²,

Tertemiz³

et al. 2017

J Sleep Disord Ther

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In this study, we aimed to evaluate the effect of CPAP treatment on hemograms of patients with severe OSA in the lack of comorbidities which might affect the real values of hematological parameters.This retrospective cohort study patients selected from those whose polysomnography reports were compatible with severe OSAS and who underwent PAP titration in our sleep medicine department. 49 patients were enrolled to the study. The baseline hemograms of the participants were collected from one of the patients' visits before they started to use CPAP devices. The control hemograms were evaluated from one of the control visits in the first six months of treatment. We examined the red cell distribution width (RDW), mean platelet volume (MPV), hemotocrit (Hct) and platelet (Plt) count from the hemograms.The mean age was 58.2 years ± 11.3 years, 38.8% were female and 61.2% were male. 69.4% were non-smokers and 30.6% were ex-smokers. The mean body mass index (BMI) was 31.6 ± 5.8 while the mean apnea hypopnea index (AHI) was 50.2 ± 29. The mean duration of CPAP therapy was 4.8 months ± 3.3 months. The mean RDW, MPV, Hct and Plt count values before CPAP treatment were in normal ranges of laboratory tests. All of the values reduced after CPAP therapy but only the decrease in MPV was statistically significant.The reduced values supported that CPAP treatment helped to control hypercoagulability and prevented from cardiovascular disorders in OSAS. Hemogram may be a cheap and easily found laboratory test for monitoring the response to CPAP therapy.

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“…Carotid artery IMT was assessed by B-mode ultrasound scanning with a 7.5-MHz linear phase array transducer (Prosoundα10, Hitachi- Repeated hypoxia during sleep in patients with OSA may induce systemic inflammation and oxidative stress [22,23] and as a result, contribute to the development of endothelial dysfunction [17]. Endothelial dysfunction promotes the development and clinical manifestation of atherosclerosis.…”

Section: Carotid Imtmentioning

confidence: 99%

Beneficial effects of CPAP treatment on endothelial function in patients with mild to moderate obstructive sleep apnea

Miyata¹,

Noda²,

Yasuda³

et al. 2017

Cardiovasc Disord Med

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Purpose: Obstructive sleep apnea (OSA) is associated with endothelial dysfunction, which may contribute to the onset of atherosclerosis and associated complications. Flow-mediated dilation (FMD) is routinely used as a noninvasive technique to evaluate endothelial function. The aim of the study was to investigate the impact of continuous positive airway pressure (CPAP) treatment on endothelial function in OSA. Methods:A cohort of twenty-five patients with OSA (age 53.8 ± 11.8 years) and 17 age-matched controls (age 48.1 ± 15.1 years) were included in the study. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using a plethysmography. FMD was evaluated using high-resolution ultrasound with a 7.5 MHz linear array transducer. The % FMD index was calculated as (maximum diameter -baseline diameter) / (baseline diameter) × 100. Maximum carotid intimamedia thickness (max IMT) was also determined.Results: % FMD was significantly lower in OSA patients compared to controls (3.3 ± 1.9 vs. 5.0 ± 1.9, P=0.009) while SBP, DBP, and max IMT did not significantly differ between the two groups. In OSA patients showing good CPAP adherence (defined as CPAP usage ≥4 h/night and 70% of nights), % FMD improved from 1.7 to 3.1 in the absence of any significant decrease in SBP or DBP. Conclusion:Although there was no difference in max IMT between OSA patients and control subjects, % FMD was significantly decreased in OSA patients. More particularly, our results suggest that good adherence to CPAP treatment might reverse endothelial dysfunction in these patients.

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Silent Brain Infarction and Platelet Activation in Obstructive Sleep Apnea

Abstract: These results suggest that serum levels of sCD40L and sP-selectin are elevated and SBI is more common in patients with moderate to severe OSA, leading to elevated cerebrovascular morbidity. Moreover, nCPAP may be useful for decreasing risk in patients with moderate to severe OSA.

Cited by 197 publications

References 41 publications

Sleep Apnea and Cardiovascular Disease

Sleep Apnea and Cardiovascular Disease

Effect of Continuous Positive Airway Pressure Treatment on Hemograms of Patients with Severe Obstructive Sleep Apnea in the Lack of Comorbidities

Beneficial effects of CPAP treatment on endothelial function in patients with mild to moderate obstructive sleep apnea

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