Korean Circ J.  2015 Nov;45(6):500-509. 10.4070/kcj.2015.45.6.500.

A Novel Echocardiographic Method for Assessing Arterial Stiffness in Obstructive Sleep Apnea Syndrome

• Akdag S
• Akyol A
• Cakmak HA
• Gunbatar H
• Asker M
• Babat N
• Tosu AR
• Yaman M
• Gumrukcuoglu HA

• KMID: 2223789
• DOI: http://doi.org/10.4070/kcj.2015.45.6.500

Abstract

BACKGROUND AND OBJECTIVES
Obstructive sleep apnea syndrome (OSAS) is associated with increased arterial stiffness and cardiovascular complications. The objective of this study was to assess whether the color M-mode-derived propagation velocity of the descending thoracic aorta (aortic velocity propagation, AVP) was an echocardiographic marker for arterial stiffness in OSAS.
SUBJECTS AND METHODS
The study population included 116 patients with OSAS and 90 age and gender-matched control subjects. The patients with OSAS were categorized according to their apnea hypopnea index (AHI) as follows: mild to moderate degree (AHI 5-30) and severe degree (AHI> or =30). Aortofemoral pulse wave velocity (PWV), carotid intima-media thickness (CIMT), brachial artery flow-mediated dilatation (FMD), and AVP were measured to assess arterial stiffness.
RESULTS
AVP and FMD were significantly decreased in patients with OSAS compared to controls (p<0.001). PWV and CIMT were increased in the OSAS group compared to controls (p<0.001). Moreover, AVP and FMD were significantly decreased in the severe OSAS group compared to the mild to moderate OSAS group (p<0.001). PWV and CIMT were significantly increased in the severe group compared to the mild to moderate group (p<0.001). AVP was significantly positively correlated with FMD (r=0.564, p<0.001). However, it was found to be significantly inversely related to PWV (r=-0.580, p<0.001) and CIMT (r=-0.251, p<0.001).
CONCLUSION
The measurement of AVP is a novel and practical echocardiographic method, which may be used to identify arterial stiffness in OSAS.

Keyword

Aortic velocity propagation; Obstructive sleep apnea; Vascular stiffness; Pulse wave analysis; Echocardiography

MeSH Terms

Aorta, Thoracic
Apnea
Brachial Artery
Carotid Intima-Media Thickness
Dilatation
Echocardiography*
Humans
Pulse Wave Analysis
Sleep Apnea, Obstructive*
Vascular Stiffness*

Figure

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  Fig. 1 Measurement of descending aorta propagation velocity: in a patient with the obstructive sleep apnea syndrome (A) and a subject in the control group (B). The aortic flow propagation velocity was calculated by dividing the distance between points corresponding to the beginning and end of the propagation slope by the duration between corresponding time points. DR: deceleration rate, CFM: color-flow mapping, PRF: pulse repetition frequency, LVR: left ventricular remodeling.

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  Fig. 2 The error bar of AVP in patients with and without the obstructive sleep apne syndrome, AVP: aortic velocity propagation; OSAS: obstructive sleep apnea syndrome; SE: Standard error.

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  Fig. 3 Scatter plot of AVP for AHI. AVP: aortic velocity propagation, AHI: apnea hypopnea index.

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  Fig. 4 Scatter plot of AVP for FMD (A), AVP for PWV (B), AVP for CIMT (C). AVP: aortic velocity propagation, FMD: flow-mediated dilatation, PWV: pulse wave velocity, CIMT: carotid intima-media thickness.

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