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Endothelial dysfunction in obstructive sleep apnea patients.

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Obstructive sleep apnea syndrome (OSAS) increases endothelial damage and affects heart function, indicated by elevated biomarkers. Long-term CPAP treatment did not significantly alter these biomarkers in patients with moderate-to-severe OSAS.

Keywords:
CPAPEndothelin-1SICAM-1Thrombin-antithrombin complexVon Willebrand factor

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Area of Science:

  • Cardiology
  • Sleep Medicine
  • Pulmonology

Background:

  • Obstructive sleep apnea syndrome (OSAS) is a significant independent risk factor for cardiovascular diseases.
  • OSAS is associated with endothelial dysfunction and pro-thrombotic states.
  • Understanding the impact of OSAS on specific biomarkers is crucial for cardiovascular risk assessment.

Purpose of the Study:

  • To assess the influence of OSAS on endothelial dysfunction and thrombosis biomarkers.
  • To evaluate the effect of continuous positive airway pressure (CPAP) treatment on these biomarker levels.

Main Methods:

  • Measured NT-proBNP, sICAM-1, endothelin-1, von Willebrand factor, D-dimers, and thrombin-antithrombin complex (TAT) in 50 moderate-to-severe OSAS patients.
  • Performed transthoracic echocardiography.
  • Reassessed biomarkers in 16 CPAP users and 22 non-CPAP users after 38 months.

Main Results:

  • Higher apnea-hypopnea index (AHI) and lower SpO2 correlated with increased sICAM-1.
  • Obesity, particularly BMI ≥ 40, was linked to higher sICAM-1.
  • TAT levels correlated with increased right ventricular size, and endothelin-1 with decreased right ventricular function.
  • Increased NT-proBNP was related to impaired right ventricular contractile function.
  • No significant correlations were found between long-term CPAP therapy and biomarker levels.

Conclusions:

  • Severe OSAS contributes to endothelial damage (elevated sICAM-1) and right ventricular dysfunction (elevated TAT, endothelin-1, NT-proBNP).
  • Long-term CPAP treatment did not appear to modify these biomarkers in moderate-to-severe OSAS patients.
  • These findings may explain the limited impact of CPAP on cardiovascular risk reduction in this population.