title: Obstructive sleep apnoea syndrome, endothelial function and markers of endothelialization. Changes after CPAP.
abstract: OBJECTIVE
  This study tries to assess the endothelial function in vivo using flow-mediated dilatation (FMD) and several biomarkers of endothelium formation/restoration and damage in patients with obstructive sleep apnoea (OSA) syndrome at baseline and after three months with CPAP therapy.
  
  
  METHODS
  Observational study, before and after CPAP therapy.
  
  
  METHODS
  We studied 30 patients with apnoea/hypopnoea index (AHI) >15/h that were compared with themselves after three months of CPAP therapy. FMD was assessed non-invasively in vivo using the Laser-Doppler flowmetry. Circulating cell-free DNA (cf-DNA) and microparticles (MPs) were measured as markers of endothelial damage and the vascular endothelial growth factor (VEGF) was determined as a marker of endothelial restoration process.
  
  
  RESULTS
  After three month with CPAP, FMD significantly increased (1072.26 ± 483.21 vs. 1604.38 ± 915.69 PU, p< 0.005) cf-DNA and MPs significantly decreased (187.93 ± 115.81 vs. 121.28 ± 78.98 pg/ml, p<0.01, and 69.60 ± 62.60 vs. 39.82 ± 22.14 U/μL, p<0.05, respectively) and VEGF levels increased (585.02 ± 246.06 vs. 641.11 ± 212.69 pg/ml, p<0.05). These changes were higher in patients with more severe disease. There was a relationship between markers of damage (r = -0.53, p<0.005) but not between markers of damage and restoration, thus suggesting that both types of markers should be measured together.
  
  
  CONCLUSIONS
  CPAP therapy improves FMD. This improvement may be related to an increase of endothelial restoration process and a decrease of endothelial damage.
authors: Laboratorio de Hipertensión Arterial e Hipercolesterolemia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
authors: Rocio
authors: R
authors: Muñoz-Hernandez
authors: Laboratorio de Hipertensión Arterial e Hipercolesterolemia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
authors: Antonio J
authors: AJ
authors: Vallejo-Vaz
authors: Unidad del Sueño, Unidad Medico Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, Spain.
authors: Angeles
authors: A
authors: Sanchez Armengol
authors: Departamento de Fisiopatología Vascular, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain.
authors: Rafael
authors: R
authors: Moreno-Luna
authors: Laboratorio de Hipertensión Arterial e Hipercolesterolemia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain; Unidad del Sueño, Unidad Medico Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, Spain.
authors: Candela
authors: C
authors: Caballero-Eraso
authors: Servicio de Bioquímica Clínica, Hospital Virgen del Rocío, Sevilla, Spain.
authors: Hada C
authors: HC
authors: Macher
authors: Laboratorio de Hipertensión Arterial e Hipercolesterolemia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain; Unidad Clínico Experimental de Riesgo Vascular (UCAMI), Hospital Virgen del Rocío, Sevilla, Spain.
authors: Jose
authors: J
authors: Villar
authors: Instituto de Investigación Biomédica Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Ana M
authors: AM
authors: Merino
authors: UGC de Radiología, Hospital Virgen del Rocío, Sevilla, Spain.
authors: Javier
authors: J
authors: Castell
authors: Unidad del Sueño, Unidad Medico Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, Spain.
authors: Francisco
authors: F
authors: Capote
authors: Laboratorio de Hipertensión Arterial e Hipercolesterolemia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain; Unidad Clínico Experimental de Riesgo Vascular (UCAMI), Hospital Virgen del Rocío, Sevilla, Spain.
authors: Pablo
authors: P
authors: Stiefel
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D055252:Cell-Derived Microparticles / Q000473:pathology; D045422:Continuous Positive Airway Pressure; D004247:DNA / Q000097:blood; D004730:Endothelium, Vascular / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000628:therapy*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A; D004247:DNA