Vascular endothelial dysfunction in patients with mild obstructive sleep apnea syndrome.

Hans-Werner Duchna Riccardo Stoohs Christian Guilleminault Marie Christine Anspach Gerhard Schultze-Werninghaus Maritta Orth

Wien Med Wochenschr

University Hospital Bergmannsheil, Ruhr-University Bochum, Medical Clinic III, Pulmonary Medicine, Allergology, Sleep- and Ventilatory Medicine, Bochum, Germany.

Published: November 2006

A study was conducted to examine the effects of mild obstructive sleep apnea syndrome (OSAS) on endothelial function, which is an early sign of atherosclerosis, in different groups of patients.
The results showed that patients with mild OSAS had significantly reduced endothelium-dependent vasodilation compared to healthy individuals, but endothelium-independent vasodilation remained unchanged.
After receiving continuous positive airway pressure (CPAP) therapy for several months, patients with mild OSAS showed significant improvement in endothelial function, highlighting the benefits of CPAP treatment for cardiovascular health.

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.

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http://dx.doi.org/10.1007/s10354-006-0341-2	DOI Listing

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