Underdiagnosis of Obstructive Sleep Apnoea in Peripheral Arterial Disease使用 SOMNOcheck micro

Carmen Pizarro¹, Christian Schaefer, Irene Kimeu, Simon Pingel, Fritz Horlbeck, Izabela Tuleta, Georg Nickenig, Dirk SkowaschAffiliations expand

PMID: 25720463
DOI: 10.1159/000371355

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Abstract

卡门·皮萨罗¹, 基督教舍费尔，艾琳Kimeu ，西蒙Pingel ，弗里茨Horlbeck ，伊莎贝拉Tuleta ，乔治·Nickenig ，德克·斯科瓦施隶属关系扩张

PMID： 25720463
DOI： 10.1159/000371355

Background: Obstructive sleep apnoea (OSA) has interdependently been related to the onset and progression of a large portion of atherosclerotic cardiovascular disorders. In due consideration of OSA-mediated endothelial dysfunction, its impact on peripheral artery disease is conceivable, but undefined. Objectives: The aim of this study was to identify the prevalence of OSA in a lower extremity artery disease (LEAD) study population. Methods: A total of 91 patients receiving in- and outpatient treatment for LEAD were included in this prospectively conducted trial. In addition to an angiological examination, all patients underwent nocturnal screening for sleep-disordered breathing by use of SOMNOcheck micro® (SC micro) and – depending on the results obtained – polysomnography. Results: Patients were principally late middle-aged (69.3 ± 10.8 years), male (71.4%) and slightly overweight (BMI 26.8 ± 3.9). Overnight screening determined a sleep apnoea prevalence of 78.0%, of which 90.1% exhibited a predominantly obstructive genesis. The mean apnoea-hypopnoea index (AHI; events/h) and oxygen desaturation index (events/h) averaged 11.8 ± 13.4 and 8.9 ± 14.2, respectively. The individual AHI categories of non-pathological (<5), mild (5 to <15), moderate (15 to <30) and severe sleep apnoea (≥30) accounted for 22.0, 59.3, 13.2 and 5.5%, respectively. A distributive examination of AHI within LEAD severity groups evinced a significant association (p = 0.047). In cases of at least moderate sleep apnoea (AHI ≥15) polysomnography was performed (n = 17, 18.7% of the whole collective). Correlative analysis revealed a significant correlation between values obtained by SC micro recording and polysomnography, establishing the diagnostic accuracy of the screening results. Conclusions: OSA exhibits an important prevalence of 70.3% in LEAD patients with prior undiagnosed sleep-disordered breathing, indicating major OSA unawareness in this cardiovascular cohort. However, the impact of OSA treatment on LEAD propagation remains to be determined. © 2015 S. Karger AG, Basel.

（以下为翻译内容，可能会有出入，以上原文为准！文章摘自https://pubmed.ncbi.nlm.nih.gov/25720463/）

卡门·皮萨罗¹, 基督教舍费尔，艾琳Kimeu ，西蒙Pingel ，弗里茨Horlbeck ，伊莎贝拉Tuleta ，乔治·Nickenig ，德克·斯科瓦施隶属关系扩张

PMID： 25720463
DOI： 10.1159/000371355

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背景：阻塞性睡眠呼吸暂停 (OSA) 与大部分动脉粥样硬化性心血管疾病的发生和进展相互关联。考虑到 OSA 介导的内皮功能障碍，其对外周动脉疾病的影响是可以想象的，但尚未确定。目的：本研究的目的是确定下肢动脉疾病 (LEAD) 研究人群中 OSA 的患病率。方法：本前瞻性试验共纳入了 91 名接受 LEAD 住院和门诊治疗的患者。除了血管检查外，所有患者还通过使用 SOMNOcheck micro® (SC micro) 和多导睡眠图（取决于获得的结果）进行了睡眠呼吸障碍的夜间筛查。结果：患者主要为中晚期（69. 3 ± 10.8 岁），男性（71.4%）和轻微超重（BMI 26.8 ± 3.9）。隔夜筛查确定睡眠呼吸暂停患病率为 78.0%，其中 90.1% 表现出主要是阻塞性起源。平均呼吸暂停-低通气指数（AHI；事件/小时）和氧饱和度指数（事件/小时）分别平均为 11.8 ± 13.4 和 8.9 ± 14.2。非病理性 (<5)、轻度 (5 至 <15)、中度 (15 至 <30) 和重度睡眠呼吸暂停 (≥30) 的个体 AHI 类别分别占 22.0、59.3、13.2 和 5.5%。LEAD 严重程度组内 AHI 的分布检查表明存在显着关联（p = 0.047）。在至少中度睡眠呼吸暂停 (AHI ≥ 15) 的情况下进行了多导睡眠图检查（n = 17，占整个集体的 18.7%）。相关性分析显示 SC 微记录和多导睡眠图获得的值之间存在显着相关性，从而确定了筛查结果的诊断准确性。结论：OSA 在先前未确诊的睡眠呼吸障碍的 LEAD 患者中的患病率为 70.3%，表明该心血管队列中对 OSA 的严重不了解。然而，OSA 处理对 LEAD 传播的影响仍有待确定。© 2015 S. Karger AG，巴塞尔。