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Liu QY, Yang M, Sheng YJ, Chen XF, Wang CS, Zhang Y, Mao P, Ding CW, Chen R, Zhang YC, Liu CF. Clinical study of transcranial sonography image characteristics in patients with obstructive sleep apnea. Sleep Breath 2023; 27:1325-1332. [PMID: 36272057 DOI: 10.1007/s11325-022-02729-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 09/29/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This study aimed to explore the relationship between patients with obstructive sleep apnea (OSA) from subgroups of varying severity and substantia nigra (SN) hyperechogenicity as well as cerebral blood flow detected by transcranial sonography (TCS). The study also explored if there were differences in damage of the SN and in the cerebral blood flow between the bilateral sides. METHODS Right-handed men diagnosed with OSA by polysomnography were recruited from August 2018 to August 2020. The included patients were divided into 3 subgroups (mild, moderate, and severe OSA), and all patients underwent TCS. RESULTS Among the 157 study patients (30 with mild OSA, 25 moderate, and 102 severe), the overall prevalence of SN hyperechogenicity was 15% (23/157). The hyperechogenicity detection rates were 3% (4/157) in the right SN subgroup and 13% (20/157) in the left SN subgroup, which were significantly different. The left side always had reduced blood flow on TCS (P < 0.05). No correlation was observed between the severity of OSA and the detection rates of SN hyperechogenicity (P > 0.05). CONCLUSION Patients with OSA showed a higher detection rate of SN hyperechogenicity on the left compared with the right side. The left middle cerebral arteries had reduced blood flow, which was consistent with the more severe damage of the left SN. No relationship was observed between the severity of OSA and the detection rate of SN hyperechogenicity or hemodynamic parameters.
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Affiliation(s)
- Qing-Yuan Liu
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Min Yang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Yu-Jing Sheng
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Xiao-Fang Chen
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Cai-Shan Wang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Ying Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Pan Mao
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Chang-Wei Ding
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Rui Chen
- Department of Respiratory Medicine, Sleeping Center, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China.
| | - Ying-Chun Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China.
| | - Chun-Feng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Lavie L, Si-On E, Hoffman A. Markers of Carotid Plaque Destabilization in Patients With Sleep-Disordered Breathing. Front Neurol 2022; 13:811916. [PMID: 35250817 PMCID: PMC8888822 DOI: 10.3389/fneur.2022.811916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/14/2022] [Indexed: 11/25/2022] Open
Abstract
Sleep-disordered breathing (SDB) is a nightly respiratory condition characterized by intermittent hypoxia, leading to oxidative stress, inflammation, and atherosclerosis. However, most cellular markers of human carotid plaques in SDB have not yet been assessed. We aimed at characterizing the cellular, inflammatory, and nitro-oxidative stress markers in carotid plaques obtained from 25 patients undergoing endarterectomy and screened for SDB. Sleep studies were performed during their preoperative hospitalization night using the Watch-PAT 100 device. Oxygen desaturation index (ODI) was used for dividing patients into two groups. Fourteen patients with ODI >5 were designated as SDB and 11 patients with ODI ≤ 5 as non-SDB. Demographics, comorbidities, cardiovascular risk factors, and medications were recorded. Cellular markers in plaques were analyzed by immunofluorescence using confocal microscopy. The expression of neutrophils was identified by CD66b+ and neutrophil elastase, macrophage-foam cells were identified by CD163+, and scavenger receptors by CD68+ and CD36+ expression. Additional markers included 3-nitrotyrosine, endothelial CD31, and smooth muscle cell-actin (SMC-actin). Plaques' lipids were determined by immunohistochemistry with Oil Red O staining. Notably, significantly higher values were found for SDB as compared to patients with non-SDB for 3-nitrotyrosine (p <0.004) and intracellular lipids' content (p <0.02), whereas SMC-actin was lower (p <0.006). There were no significant differences between patients with carotid-associated symptoms (symptomatic) and patients without carotid-associated symptoms (asymptomatic). However, a sub-group of symptomatic patients with co-existent SDB expressed the highest 3-nitrotyrosin, and intracellular lipids levels, and the lowest SMC-actin levels, whereas non-SDB/asymptomatic patients expressed the lowest 3-nitrotyrosin and lipids levels and the highest SMS-actin levels among all patients. Accordingly, ODI was lowest in non-SDB/asymptomatic patients and highest in SDB/symptomatic. In conclusion, plaques of patients with SDB were characterized by markedly increased levels of 3-nitrotyrosine and intracellular lipids content. Conversely, SMC-actin levels were significantly lower. These three markers, such as increased 3-nitrotyrosine and intracellular lipids and decreased SMC-actin are associated with plaque vulnerability and instability. These findings are in line with earlier reports demonstrating increased intima-media thickness in large cohorts of sleep apnea and patients with SDB, and thus, may indicate a higher susceptibility to plaque vulnerability and rapture in patients with SDB.
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Affiliation(s)
- Lena Lavie
- Unit of Anatomy and Cell Biology, The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- *Correspondence: Lena Lavie
| | - Erez Si-On
- Department of Vascular Surgery and Transplantation, Rambam Health Care Campus, The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Aaron Hoffman
- Department of Vascular Surgery and Transplantation, Rambam Health Care Campus, The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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