The relationship of vascular complications with cerebrovascular reactivity and endothelial dysfunction in patients with obstructive sleep apnea

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OBJECTIVE

To assess the relationship of vascular complications with cerebrovascular reactivity (CVR) and endothelial dysfunction in patients with obstructive sleep apnea (OSA).

MATERIAL AND METHODS

One hundred and twelve patients were examined. The patients were stratified into the main group with moderate and severe OSA and the control group without apnea. All patients underwent anthropometry, polysomnography, transcranial dopplerography and duplex scanning of the brachial artery.

RESULTS

Patients with OSA showed a more frequent decrease in post-occlusive vascular dilatation. The CVR indices in the hypercapnic test in the main group were in the range of 0.91—0.97 and significantly lower after 1 minute on the left, after 5 minutes on both sides and after 10 minutes on the left. A positive correlation during a hypercapnic test between the CVR on the left after 10 minutes and the desaturation index (r=0.287, p=0.021), between the CVR on the left after 5 and 10 minutes and acute cerebrovascular accident (r=0.248, p=0.048 and r=0.285, p=0.022, respectively), as well as a negative correlation between the indicators of the middle cerebral artery and chronic cerebral ischemia were established in patients with apnea.

CONCLUSION

Timely assessment of pathological changes in central and peripheral hemodynamics in patients with OSA will allow diagnosing early signs of vascular complications, which will further improve the personalized strategy for the prevention of stroke and chronic cerebral ischemia.

Keywords:

obstructive sleep apnea

polysomnography

transcranial dopplerography

cerebrovascular reactivity

chronic cerebral ischemia

acute cerebrovascular accident

Authors:

Rubina S.S.

Tver State Medical University

ORCID: 0000-0003-3804-6998

Makarova I.I.

Tver State Medical University

ORCID: 0000-0002-0297-3389

Yusufov A.A.

Tver State Medical University

ORCID: 0000-0002-9404-6768

Received:

13.02.2023

Accepted:

04.03.2023

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