Article
Endothelial function in normotensive men with obstructive sleep apnea before and 6 months after CPAP treatment.
Ataturk Education and Research Hospital, Cardiology Department, Ankara, Turkey.
Sleep (impact factor:
5.05).
10/2009;
32(10):1257-63.
pp.1257-63
Source: PubMed
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Article: Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up.
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ABSTRACT: The incidence of a cardiovascular disease (CVD) was explored in a consecutive sleep clinic cohort of 182 middle-aged men (mean age, 46.8 +/- 9.3; range, 30-69 years in 1991) with or without obstructive sleep apnea (OSA). All subjects were free of hypertension or other CVD, pulmonary disease, diabetes mellitus, psychiatric disorder, alcohol dependency, as well as malignancy at baseline. Data were collected via the Swedish Hospital Discharge Register covering a 7-year period before December 31, 1998, as well as questionnaires. Effectiveness of OSA treatment initiated during the period as well as age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) at baseline, and smoking habits were controlled. The incidence of at least one CVD was observed in 22 of 60 (36.7%) cases with OSA (overnight oxygen desaturations of 30 or more) compared with in 8 of 122 (6.6%) subjects without OSA (p < 0.001). In a multiple logistic regression model, significant predictors of CVD incidence were OSA at baseline (odds ratio [OR] 4.9; 95% confidence interval [CI], 1.8-13.6) and age (OR 23.4; 95% CI, 2.7-197.5) after adjustment for BMI, SBP, and DBP at baseline. In the OSA group, CVD incidence was observed in 21 of 37 (56.8%) incompletely treated cases compared with in 1 of 15 (6.7%) efficiently treated subjects (p < 0.001). In a multiple regression analysis, efficient treatment was associated with a significant risk reduction for CVD incidence (OR 0.1; 95% CI, 0.0-0.7) after adjustment for age and SBP at baseline in the OSA subjects. We conclude that the risk of developing CVD is increased in middle-aged OSA subjects independently of age, BMI, SBP, DBP, and smoking. Furthermore, efficient treatment of OSA reduces the excess CVD risk and may be considered also in relatively mild OSA without regard to daytime sleepiness.American Journal of Respiratory and Critical Care Medicine 07/2002; 166(2):159-65. · 11.08 Impact Factor -
Article: Cerebellar infarct: secondary to arteriography for the diagnosis of a buccal hemangioma.
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ABSTRACT: Angiography is a reliable diagnostic method for most of the vascular lesions. The method however is associated with complications and it is the aim of this report to present a cerebellum infarct resulting from angiography for the diagnosis of a buccal hemangioma.International Journal of Oral and Maxillofacial Surgery 03/2002; 31(1):107-9. · 1.51 Impact Factor -
Article: Treatment of obstructive sleep apnoea leads to improved microvascular endothelial function in the systemic circulation.
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ABSTRACT: Obstructive sleep apnoea (OSA) is a common and potentially reversible cause of systemic hypertension. The mechanisms whereby OSA leads to hypertension and the effects of treatment on arterial function, however, are not well established. Microvascular arterial endothelial and smooth muscle function was assessed in subjects with OSA before and after treatment with continuous positive airways pressure (CPAP). Ten subjects of mean (SE) age 49 (8) years with at least moderately severe OSA had detailed forearm vascular reactivity studies before and after 3 months of CPAP treatment. The systemic circulation was assessed by measuring brachial artery pressure, flow and resistance responses to intra-arterial infusions of acetylcholine (ACh; an endothelium dependent vasodilator), sodium nitroprusside (SNP; an endothelium independent vasodilator), L-NMMA (a nitric oxide (NO) antagonist), and L-arginine (the substrate for NO). Before CPAP, ACh and SNP infusions increased forearm blood flow in a dose dependent manner (p<0.01). After CPAP, endothelium dependent dilation to ACh was significantly increased (434 (23)% of baseline after CPAP v 278 (20)% before CPAP, p<0.001), whereas SNP induced dilation was unchanged. Resting NO production was higher after CPAP, evidenced by a significantly greater reduction in basal flow by L-NMMA (p=0.05). L-Arginine reversed the effect of L-NMMA in all cases. In patients with OSA, treatment with CPAP improves baseline endothelial NO release and stimulates endothelium dependent vasorelaxation in the systemic circulation. This is a potential mechanism for improving systemic and vascular function in patients with OSA treated with CPAP.Thorax 06/2006; 61(6):491-5. · 6.84 Impact Factor
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Keywords
20 patients compliant
6 months
additionally document
apnea-hypopnea index [AHI]
baseline values
body mass index
brachial artery
continuous positive airway pressure
corresponding values
CPAP therapy
CPAP treatment
Doppler ultrasound
endothelial function
endothelium-dependent FMD
endothelium-independent nitroglycerin
normotensive men
NTG-induced vasodilation
observational study
OSA patients
sustained improvement
