Evaluation of Cerebrovascular Reactivity in Subjects with and without Obstructive Sleep Apnea
Evaluation of Cerebrovascular Reactivity in Subjects with and without Obstructive Sleep Apnea
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DOI：
10.1016/j.jstrokecerebrovasdis.2017.08.015
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发表时间：
2018-01-01
影响因子：
2.5
通讯作者：
Venkatraghavan, Lashmi
中科院分区：
文献类型：
--
作者：
Ryan, Clodagh M.;Battisti-Charbonney, Anne;Venkatraghavan, Lashmi
背景资料：阻塞性睡眠呼吸暂停（OSA）和脑血管反应性（CVR）改变均与卒中风险增加相关。然而，由于研究内和研究间CVR测量方式的高度变异性，OSA患者中异常CVR的发生率尚不确定。我们假设，与健康对照组相比，重度OSA患者的标准化CVR与一致的血管活性刺激和脑血流量（CBF）测量值会降低。研究方法：这是一项前瞻性研究，其中对患有和不患有OSA的受试者给予标准化的高碳酸血症刺激，并通过血氧水平依赖性磁共振信号变化（CBF的高空间和时间分辨替代物）监测CBF。结果如下：24名OSA受试者（平均年龄45.9岁，呼吸暂停低通气指数[AHI] 26.8/小时）和6名对照受试者（平均年龄42.8岁，AHI 2.4/小时）被纳入。与对照组相比，OSA受试者的全脑CVR（.1565 vs.1094，P = .013）、灰质CVR（.2077 vs.1423，P = .009）和白色CVR（.1109 vs.0768，P = .024）分别显著增加。结论：与预期相反，与对照组相比，OSA患者的CVR更大。
Background: Both obstructive sleep apnea (OSA) and altered cerebrovascular reactivity (CVR) are associated with increased stroke risk Nevertheless, the incidence of abnormal CVR in patients with OSA is uncertain due to the high variability in the way CVR is measured both within and between studies. We hypothesized that a standardized CVR with a consistent vasoactive stimulus and cerebral blood flow (CBF) measure would be reduced in patients with severe OSA compared with healthy controls. Methods: This was a prospective study in which subjects with and without OSA were administered a standardized hypercapnic stimulus, and CBF was monitored by blood oxygen level-dependent magnetic resonance signal changes, a high space and time resolved surrogate for CBF. Results: Twenty-four subjects with OSA (mean age 45.9 years, apnea-hypopnea index [AHI] 26.8 per hour) and 6 control subjects (mean age 42.8 years, AHI 2.4 per hour) were included. Compared with controls, subjects with OSA had a significantly greater whole brain (.1565 versus .1094, P = .013), gray matter (.2077 versus .1423, P = .009), and white matter (.1109 versus .0768, P = .024) CVR, respectively. Conclusions: Contrary to expectations, subjects with OSA had greater CVR compared with control subjects.