Association Between Risk of Obstructive Sleep Apnea and Cerebrovascular Reactivity in Stroke Patients
| Autor: | Paulo R. S. Peixoto Sousa, Alisson L Andrade, Murilo A. Oliveira, Marília B Catto, Beatriz M Gonçalves, Saul Schnitman, Camila B Pereira, Renata M Maia, Pedro Jr Muinos, Jamary Oliveira-Filho, Leila S. Brito Santos, Maria E. Lisboa Marques, Louise M Porto, Iuri Ferreira Felix, Thiago Cerqueira-Silva, Renan C. Castello‐Branco |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Stroke patient Ultrasonography Doppler Transcranial 030204 cardiovascular system & hematology Risk Assessment transcranial Doppler 03 medical and health sciences 0302 clinical medicine Cerebrovascular reactivity Risk Factors Internal medicine Ultrasound medicine Humans cerebral vasoreactivity In patient Stroke obstructive sleep apnea Aged Dyslipidemias Original Research Ischemic Stroke Sleep Apnea Obstructive business.industry ultrasonography Middle Aged Prognosis medicine.disease Transcranial Doppler Obstructive sleep apnea Cross-Sectional Studies Metabolism Cerebrovascular Circulation Cardiology Cerebrovascular Disease/Stroke Female Ultrasonography Cardiology and Cardiovascular Medicine business Blood Flow Velocity 030217 neurology & neurosurgery |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| DOI: | 10.1161/jaha.119.015313 |
| Popis: | Background Obstructive sleep apnea ( OSA ) is present in 60% to 70% of stroke patients. Cerebral vasoreactivity in patients with stroke and OSA has not been well studied and could identify a new pathophysiologic mechanism with potential therapeutic intervention. We aimed to determine whether risk categories for OSA are associated with cerebral vasoreactivity in stroke patients. Methods and Results In this cross‐sectional study of a cohort of patients with stroke, we used clinical questionnaires (Sleep Obstructive Apnea Score Optimized for Stroke [ SOS ] and snoring, tiredness, observed, pressure, bmi, age, neck, gender [ STOP ‐ BANG ] scores) to assess the risk of OSA and transcranial Doppler to assess cerebral vasoreactivity (breath‐holding index and visual evoked flow velocity response). Of the 99 patients included, 77 (78%) had medium or high risk of OSA and 80 performed transcranial Doppler. Mean breath‐holding index was 0.52±0.37, and median visual evoked flow velocity response was 10.8% (interquartile range: 8.8–14.5); 54 of 78 (69%) showed impaired anterior circulation vasoreactivity (breath‐holding index OSA calculated by STOP ‐ BANG and the breath‐holding index ( r S =−0.284, P =0.012). The following variables were associated with low anterior circulation vasoreactivity: dyslipidemia (odds ratio: 4.7; 95% CI , 1.5–14.2) and STOP ‐ BANG score (odds ratio: 1.7 per 1‐point increase; 95% CI , 1.1–1.5). Conclusions A high risk of OSA and impaired vasoreactivity exists in the population that has had stroke. Dyslipidemia and STOP ‐ BANG sleep apnea risk categories were independently associated with impaired anterior circulation vasoreactivity. |
| Databáze: | OpenAIRE |
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