Vascular endothelial dysfunction in patients with mild obstructive sleep apnea syndrome

Wien Med Wochenschr. 2006 Nov;156(21-22):596-604. doi: 10.1007/s10354-006-0341-2.

Abstract

Background: We investigated endothelial dysfunction, an early manifestation of atherosclerosis, in patients with mild obstructive sleep apnea syndrome (OSAS) (5/h < AHI < 15/h).

Patients and methods: Endothelium-dependent and -independent vasodilatory function was tested in 10 patients with mild OSAS, 12 healthy controls and 20 subjects with moderate to severe OSAS using the hand vein compliance technique.

Results: Maximum endothelium-dependent vasodilation to bradykinin (Emax) was significantly blunted in patients with mild OSAS (68.6 +/- 30.2 %) compared to healthy controls (94.8 +/- 9.5 %; p < 0.05; moderate to severe OSAS: 57.1 +/- 23.4 %; p = 0.33). Mean endothelium-independent venodilation was not altered. After 160.7 +/- 82.2 nights of CPAP therapy, mean Emax was significantly improved to 90.8 +/- 23.8 % (p < 0.01 vs. baseline; p = 0.7 vs. healthy controls) in 7 patients with mild OSAS.

Conclusions: Systemic endothelium-dependent venodilation is markedly reduced in subjects with mild OSAS, which may imply adverse cardiovascular consequences. CPAP-treatment leads to a sustained restoration of endothelial dysfunction in these patients and is thus highly recommended.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Atherosclerosis / diagnosis*
  • Atherosclerosis / etiology
  • Body Mass Index
  • Bradykinin / administration & dosage
  • Continuous Positive Airway Pressure
  • Data Interpretation, Statistical
  • Dose-Response Relationship, Drug
  • Endothelium, Vascular / physiopathology*
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Nitroglycerin / administration & dosage
  • Patient Selection
  • Polysomnography
  • Regression Analysis
  • Sleep Apnea, Obstructive / complications
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / physiopathology*
  • Sleep Apnea, Obstructive / therapy
  • Vasodilation
  • Vasodilator Agents / administration & dosage
  • Veins / physiopathology

Substances

  • Vasodilator Agents
  • Nitroglycerin
  • Bradykinin