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PLoS One. 2015 Mar 27;10(3):e0122091. doi: 10.1371/journal.pone.0122091. eCollection 2015.

Obstructive sleep apnoea syndrome, endothelial function and markers of endothelialization. Changes after CPAP.

Author information

1
Laboratorio de Hipertensión Arterial e Hipercolesterolemia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
2
Unidad del Sueño, Unidad Medico Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, Spain.
3
Departamento de Fisiopatología Vascular, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain.
4
Laboratorio de Hipertensión Arterial e Hipercolesterolemia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain; Unidad del Sueño, Unidad Medico Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, Spain.
5
Servicio de Bioquímica Clínica, Hospital Virgen del Rocío, Sevilla, Spain.
6
Laboratorio de Hipertensión Arterial e Hipercolesterolemia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain; Unidad Clínico Experimental de Riesgo Vascular (UCAMI), Hospital Virgen del Rocío, Sevilla, Spain.
7
Instituto de Investigación Biomédica Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
8
UGC de Radiología, Hospital Virgen del Rocío, Sevilla, Spain.

Abstract

STUDY OBJECTIVES:

This study tries to assess the endothelial function in vivo using flow-mediated dilatation (FMD) and several biomarkers of endothelium formation/restoration and damage in patients with obstructive sleep apnoea (OSA) syndrome at baseline and after three months with CPAP therapy.

DESIGN:

Observational study, before and after CPAP therapy.

SETTING AND PATIENTS:

We studied 30 patients with apnoea/hypopnoea index (AHI) >15/h that were compared with themselves after three months of CPAP therapy. FMD was assessed non-invasively in vivo using the Laser-Doppler flowmetry. Circulating cell-free DNA (cf-DNA) and microparticles (MPs) were measured as markers of endothelial damage and the vascular endothelial growth factor (VEGF) was determined as a marker of endothelial restoration process.

MEASUREMENTS AND RESULTS:

After three month with CPAP, FMD significantly increased (1072.26 ± 483.21 vs. 1604.38 ± 915.69 PU, p< 0.005) cf-DNA and MPs significantly decreased (187.93 ± 115.81 vs. 121.28 ± 78.98 pg/ml, p<0.01, and 69.60 ± 62.60 vs. 39.82 ± 22.14 U/μL, p<0.05, respectively) and VEGF levels increased (585.02 ± 246.06 vs. 641.11 ± 212.69 pg/ml, p<0.05). These changes were higher in patients with more severe disease. There was a relationship between markers of damage (r = -0.53, p<0.005) but not between markers of damage and restoration, thus suggesting that both types of markers should be measured together.

CONCLUSIONS:

CPAP therapy improves FMD. This improvement may be related to an increase of endothelial restoration process and a decrease of endothelial damage.

PMID:
25815511
PMCID:
PMC4376903
DOI:
10.1371/journal.pone.0122091
[Indexed for MEDLINE]
Free PMC Article

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