Relationship between atherosclerosis and the sleep apnea syndrome: An intravascular ultrasound study

BackgroundSleep apnea hypopnea syndrome (SAHS) is a predictive factor of cardiovascular disease. We hypothesized that SAHS could influence coronary atherosclerosis plaque volume as assessed by 3-dimensional intravascular ultrasound (3D-IVUS).MethodsParticipating patients were identified from 2 studies assessing the progression of atherosclerosis in stable coronary artery disease using coronary 3D-IVUS.ResultsNineteen patients, aged 61 ± 8 years, with a body mass index of 29 ± 5 kg/m2 were studied. Increased apnea–hypopnea index (AHI) ≥ 15 was found in 12/19 patients (63%). Patients with AHI ≥ 15 had larger coronary atherosclerotic plaque volume than patients with AHI < 15 (238 ± 69 mm3 vs 169 ± 64 mm3, p = 0.047) and the difference was even larger in patients with obstructive apnea/hypopnea episodes compared to patients without (243 ± 70 mm3 vs 170 ± 59 mm3, p = 0.03). There was a significant positive correlation between obstructive AHI and coronary atherosclerotic plaque volume (r = 0.6, p = 0.01). A significant positive correlation was also demonstrated between respiratory arousal index and coronary atherosclerotic plaque volume (r = 0.6, p = 0.02) and between total arousal index and coronary atherosclerotic plaque volume (r = 0.5, p = 0.03).ConclusionIn patients with stable coronary artery disease, there was a significant relationship between the frequency of obstructive sleep apnea/hypopnea episodes and sleep fragmentation and the importance of coronary atherosclerotic plaque volume. 3D-IVUS is well suited to correlate coronary atherosclerosis and sleep breathing disorders at early stages.