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Altered clot microstructure detected in obstructive sleep apnoea hypopnoea syndrome
Lindsay D'Silva1, Maria Wilczynska2, Keir Lewis3
1College of Medicine, Institute of Life Science, Swansea University, Swansea, United Kingdom; NISCHR Haemostasis Biomedical Research Unit, Morriston Hospital, Swansea, Abertawe Bro Morgannwg University Health Board, Swansea SA6 6NL, United Kingdom.
Sleep Science (Sao Paulo, Brazil)
|May 27, 2016
Summary
Obstructive Sleep Apnoea Hypopnea Syndrome (OSAHS) patients exhibit altered clot microstructure, with Fractal Dimension (d f ) being lower in the afternoon. This diurnal change in d f may indicate compensatory mechanisms against nocturnal clotting abnormalities.
Area of Science:
- Hemostasis and Thrombosis
- Sleep Medicine
- Cardiovascular Pathophysiology
Background:
- Abnormal clot microstructure is central to thromboembolic disease.
- Obstructive Sleep Apnoea Hypopnea Syndrome (OSAHS) is linked to increased cardiovascular and thromboembolic events.
- Novel viscoelastic parameters like Fractal Dimension (d f ) may offer insights into clot abnormalities.
Purpose of the Study:
- To compare clot microstructure parameters (Time to Gel Point, Fractal Dimension, clot elasticity) and their diurnal variation in OSAHS patients versus symptomatic comparators.
- To investigate the relationship between diurnal changes in clot microstructure and other physiological markers.
Main Methods:
- Recruited 36 patients with suspected OSAHS.
- Measured Time to Gel Point (T GP ), Fractal Dimension (d f ), and clot elasticity (G׳ GP ) at 16:00h and 07:30h.
- Conducted standard coagulation screening, thrombin generation assays, and platelet aggregometry.
Main Results:
- OSAHS patients showed significantly lower afternoon d f compared to controls (1.705±0.033 vs. 1.731±0.031, p<0.05).
- Fractal Dimension (d f ) exhibited diurnal variation only in OSAHS patients, decreasing from morning to afternoon (p<0.05).
- Diurnal d f changes correlated with 4% DR, independent of BMI (r=0.37, p=0.02).
Conclusions:
- Lower afternoon d f in OSAHS suggests a potential compensatory mechanism against nocturnal pro-thrombotic changes.
- Diurnal variation in d f appears linked to OSAHS severity and may serve as a novel indicator of hemostatic abnormalities.
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