Endothelial Dysfunction and Arterial Stiffness in Ischemic Stroke The Role of Sleep-Disordered Breathing
Endothelial Dysfunction and Arterial Stiffness in Ischemic Stroke The Role of Sleep-Disordered Breathing
复制标题
DOI：
10.1161/strokeaha.111.000112
复制
发表时间：
2013-04-01
期刊：
影响因子：
8.3
通讯作者：
Bassetti, Claudio L.
中科院分区：
文献类型：
--
作者：
Cereda, Carlo W.;Tamisier, Renaud;Bassetti, Claudio L.
背景和目的——睡眠呼吸障碍（SDB）是脑缺血事件（急性缺血事件、缺血性中风或短暂性脑缺血发作）后心血管发病的危险因素。在本研究中，分析了经历急性缺血事件的患者的内皮功能和动脉僵硬度与 SDB、睡眠中断和夜间氧合参数的关系。方法-在我们卒中科室入院 3 个月后，通过全面多导睡眠图对发生急性缺血事件的患者进行 SDB 评估。根据呼吸暂停低通气指数定义为中重度 SDB，即呼吸暂停低通气指数≥20。使用 Endo-PAT 2000 通过外周动脉张力测定法评估内皮功能和动脉僵硬度。结果-纳入 37 名患者。呼吸暂停低通气指数 = 20 的患者之间的增强指数存在显着差异（22.4 +/- 15.6% 与 34.6 +/- 21.6%；P=0.042），而反应性充血指数水平则没有显着差异（2.02 +/- 0.65 与 2.31 +/- 0.61；P=0.127）。即使控制了年龄、性别、体重指数、高血压和糖尿病，呼吸暂停低通气指数 >= 20 的患者动脉硬化风险也增加（比值比，5.98 [95% CI，1.11-41.72]）。增强指数与觉醒指数（P=0.010）和平均O-2饱和度（P=0.043）相关。结论：中重度SDB的中风后患者更容易出现动脉僵硬度增加，尽管我们没有发现内皮功能存在显着差异。动脉僵硬度还与睡眠中断（觉醒指数）和平均 O-2 饱和度相关。 （中风。2013；44：1175-1178。）
Background and Purpose-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 (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 O-2 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 O-2 saturation. (Stroke. 2013;44:1175-1178.)