Sleep-Disordered Breathing in Acute Ischemic Stroke: A Mechanistic Link to Peripheral Endothelial Dysfunction

Area of Science:

• Neurology
• Cardiology
• Pulmonology

Background:

• Sleep-disordered breathing (SDB) is a frequent complication following acute ischemic stroke.
• SDB may contribute to stroke-induced autonomic imbalance and peripheral endothelial dysfunction (ED).

Purpose of the Study:

• To investigate the interaction between SDB and peripheral ED in acute ischemic stroke patients.
• To assess the changes in SDB and ED at 1-year follow-up.

Main Methods:

• 101 acute ischemic stroke patients were assessed for SDB using transthoracic impedance records.
• Peripheral endothelial function was evaluated using peripheral arterial tonometry (EndoPAT-2000).
• 41 patients completed a 1-year follow-up assessment.

Main Results:

• SDB was present in 57% of acute ischemic stroke patients.
• Endothelial dysfunction (ED) was significantly more prevalent in patients with SDB (64% vs. 32%).
• SDB remained independently associated with ED after adjusting for confounders (OR, 3.1; P<0.05).
• At 1-year follow-up, SDB prevalence decreased from 59% to 15% (P<0.001).
• Peripheral endothelial function improved in patients whose SDB normalized, compared to those with persistent SDB (P<0.05).

Conclusions:

• Over half of acute ischemic stroke patients exhibit SDB, which is independently linked to peripheral ED.
• The normalization of ED alongside improved breathing patterns at 1-year post-stroke suggests a mechanistic relationship between SDB and ED.