title: Atherosclerosis and arterial stiffness in obstructive sleep apnea--a cardiovascular magnetic resonance study.
abstract: OBJECTIVE
  Obstructive sleep apnoea (OSA) has been linked to cardiovascular risk factors, such as hypertension, and clinical cardiovascular endpoints. Our aim was to assess whether OSA is independently associated with atherosclerosis and vascular dysfunction as assessed by cardiovascular magnetic resonance (CMR).
  
  
  METHODS
  58 patients with OSA and 39 matched control subjects without OSA underwent CMR of the aorta and carotid arteries. Carotid and aortic wall thickness and aortic distensibility were measured. Multi-weighted, high resolution CMR imaging was used for carotid atheroma characterization according to the American Heart Association (AHA) atheroma classification, modified for CMR.
  
  
  RESULTS
  Carotid [1.47±0.03 mm vs. 1.26±0.05 mm, (P<0.01)] and aortic wall thickness [2.95±0.09 mm vs. 2.05±0.07 mm, (P<0.001)] were increased in patients with OSA compared to controls. Aortic distensibility was decreased in patients with OSA [3.62±0.3 vs. 4.75±0.2 mmHg(-1)×10(-3), (P<0.05)]. Prevalence of carotid plaque, average carotid atheroma class, and prevalence of high risk features of carotid atheroma were increased in patients with OSA (P<0.005 for all). On multivariate analysis, Oxygen desaturation index (ODI) emerged as an independent predictor of carotid and aortic wall thickness, but not of aortic stiffness.
  
  
  CONCLUSIONS
  OSA is associated with increased carotid and aortic atheroma burden and with advanced, high risk carotid atherosclerotic plaques, but not with aortic stiffening.
authors.affiliation: Oxford Centre for Clinical Magnetic Resonance Research, Department of Cardiovascular Medicine, University of Oxford, Oxford, UK. ilias_kylintireas@yahoo.co.uk
authors.forename: Ilias
authors.initials: I
authors.lastname: Kylintireas
authors.forename: Sonya
authors.initials: S
authors.lastname: Craig
authors.forename: Richard
authors.initials: R
authors.lastname: Nethononda
authors.forename: Malcolm
authors.initials: M
authors.lastname: Kohler
authors.forename: Jane
authors.initials: J
authors.lastname: Francis
authors.forename: Robin
authors.initials: R
authors.lastname: Choudhury
authors.forename: John
authors.initials: J
authors.lastname: Stradling
authors.forename: Stefan
authors.initials: S
authors.lastname: Neubauer
mesh_terms: D050153:Abdominal Fat / Q000473:pathology; D001013:Aorta, Thoracic / Q000473:pathology* / Q000503:physiopathology; D001018:Aortic Diseases / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D050197:Atherosclerosis / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000453:epidemiology / Q000473:pathology*; D017536:Carotid Artery, Common / Q000473:pathology*; D016022:Case-Control Studies; D003187:Compliance; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D016014:Linear Models; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015995:Prevalence; D011673:Pulsatile Flow; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*