Is there a correlation between OSAS duration/severity and carotid intima-media thickness?
BACKGROUND
Obstructive Sleep Apnea Syndrome (OSAS) is a common airways disease recognized as an independent cardiovascular risk factor. It is often associated with obesity, diabetes and dyslipidemia. Its pathophysiological consequences (hypoxia, hypercapnia, micro-arousals, sympathetic hyperactivity, oxidative stress, systemic inflammation and hyper-coagulability) are implicated in the development of hypertension, endothelial dysfunction and higher intima-media thickness (IMT) values, all elements known to lead to atherosclerosis. The study aim was to demonstrate a relationship between OSAS duration and IMT values and to confirm how OSAS severity could influence IMT (a marker of atherosclerosis).


METHODS
We enrolled 156 patients (125 men, mean age: 60 ± 12 years) affected by OSAS of different severity: 111 (71%) were in CPAP therapy; some of the population were also affected by hypertension [102 (65%)], dyslipidemia [52 (33%)] and diabetes [38 (24%)]. Patients underwent evaluation of carotid artery IMT and answered a questionnaire investigating the time of onset (confirmed by a person aware of the patient's previous sleeping habits) and the duration of the disease.


RESULTS
We found a statistically significant higher IMT value in patients with longer-lasting disease (OSAS duration in IMT < 0.9 mm: 120 (60-192) months versus OSAS duration in IMT ≥ 0.9 mm: 200 (120-310) months; p < 0.001). OSAS severity is positively related to IMT values. We found a positive relationship between IMT and OSAS duration [r = 0.34; p < 0.001] and between AHI and IMT [r = 0.51; p < 0.001].


CONCLUSIONS
Our study shows that the duration of OSAS and its severity are important factor related with higher values of IMT and hence with a higher risk of atherosclerosis.
Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare, 70124 Bari, Italy. ciccone@cardio.uniba.it
Marco Matteo
MM
Ciccone
Pietro
P
Scicchitano
Gianfranco
G
Mitacchione
Annapaola
A
Zito
Michele
M
Gesualdo
Paola
P
Caputo
Mario Francesco
MF
Damiani
Marco
M
Sassara
Stefano
S
Favale
Onofrio
O
Resta
Pierluigi
P
Carratù
D000368:Aged; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color