title: Endothelial dysfunction and arterial stiffness in ischemic stroke: the role of sleep-disordered breathing.
abstract: OBJECTIVE
  Sleep-disordered breathing (SDB) represents a risk factor for cardiovascular morbidity after a cerebral ischemic event (acute ischemic event, ischemic stroke, or transient ischemic attack). In the present study, endothelial function and arterial stiffness were analyzed in patients who experienced a postacute ischemic event with relation to SDB, sleep disruption, and nocturnal oxygenation parameters.
  
  
  METHODS
  SDB was assessed by full polysomnography in patients with acute ischemic event 3 months after the admission at our stroke unit. Moderate-severe SDB was defined according to the apnea-hypopnea index as apnea-hypopnea index ≥ 20. Endothelial function and arterial stiffness were assessed by peripheral arterial tonometry using Endo-PAT 2000.
  
  
  RESULTS
  Thirty-seven patients were included. The augmentation index was significantly different between patients with apnea-hypopnea index <20 and apnea-hypopnea index ≥ 20 (22.4 ± 15.6% versus 34.6 ± 21.6%; P=0.042), whereas reactive hyperemia index level was not (2.02 ± 0.65 versus 2.31 ± 0.61; P=0.127). Patients with apnea-hypopnea index ≥ 20 showed an increased risk for arterial stiffness (odds ratio, 5.98 [95% CI, 1.11-41.72]) even when controlling for age, sex, body mass index, hypertension, and diabetes mellitus. The augmentation index was correlated with the arousal index (P=0.010) and with mean O2 saturation (P = 0.043).
  
  
  CONCLUSIONS
  Poststroke patients with moderate-severe SDB were more prone to have increased arterial stiffness, although we did not find significant differences in endothelial function. Arterial stiffness also correlated with sleep disruption (arousal index) and mean O2 saturation.
authors.affiliation: Universitätsklinik für Neurologie, Inselspital, 3010 Bern, Switzerland. claudio.bassetti@insel.ch.
authors.forename: Carlo W
authors.initials: CW
authors.lastname: Cereda
authors.forename: Renaud
authors.initials: R
authors.lastname: Tamisier
authors.forename: Mauro
authors.initials: M
authors.lastname: Manconi
authors.forename: Jennifer
authors.initials: J
authors.lastname: Andreotti
authors.forename: Jane
authors.initials: J
authors.lastname: Frangi
authors.forename: Valeria
authors.initials: V
authors.lastname: Pifferini
authors.forename: Claudio L
authors.initials: CL
authors.lastname: Bassetti
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000628:therapy*; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010100:Oxygen / Q000378:metabolism; D017286:Polysomnography; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000503:physiopathology; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D059289:Vascular Stiffness
chemical_list: D010100:Oxygen