The Relation Among Coronary Artery Disease, Pulse Wave Velocity And Obstructive Sleep Apnea Syndrome

Part1GY-6620，a new portable device, may accurately diagnose OSAHSat home and holter monitoring of the obstructive sleep apnoea/hypopnoeasyndromeObjective:The aim of this study was to explore whether GY-6620,a newportable device, may accurately diagnose OSAHS at home and holtermonitoring of the obstructive sleep apnoea/hypopnoea syndrome (OSAS) isapplicable;Methods: A synchronous comparison to polysomnography andGY-6620in an laboratory was performed in97patients these maybe haveOSAS and an comparison of home GY-6620studies with polysomnographywas performed in65patients of those, then results were analyzed by ABland–Altman plot、Pearson correlation coefficient and linear regressionequation and a receiver operating characteristics (ROC) curve.Results:1) The synchronous study: a) Agreement and relationbetween PSG and GY-6620:the mean difference(polysomnography–GY-6620) in AHI,the mean oxygen saturation, Lowestoxygen saturation, ODI3and ODI4was respectively2,0.9,0.9,0.2,3.7;GY-6620results in AHI,the mean oxygen saturation, Lowest oxygensaturation,ODI3and ODI4showed a strong correlation (Pearson correlationcoefficients) to results from PSG;(AHI:R=0.99，the mean oxygen saturation：R=0.78，Lowest oxygen saturation R=0.91，ODI3：R=0.95; ODI4:R=0.92);b) diagnostic value of GY-6620: For diagnosing OSA, with thresholdvalue of AHI of5the AUC was0.95(CI:0.92-0.99), sensitivity andspecificity for these thresholds were calculated as82%/100%, PV-and PV+were70.7%/100%;2) an comparison of home GY-6620studies withpolysomnography: a) Data sufficiency rates of GY-6620is95%;b)Agreementand relation between PSG and GY-6620: the mean difference(polysomnography–GY-6620) in AHI was4.2,and the limits of agreementwere14.6and6events per hour,95%patients was in the range, theagreement was good; there was significant correlation between GY-6620AHIand PSG AHI(R=0.97,P<0.01);c) value of diagnosing OSAS: Receiveroperating characteristic curves in diagnosing mild OSAS demonstrated areasunder the curves (AUC) of0.98， sensitivity and specificity was89.36%/100%,PV-and PV+was66.7%/100%, while in diagnosing severOSAS AUC was also0.98, sensitivity and specificity was76.19%/94.4%, PV-and PV+was87.2%/89.9%; at AHI levels of15, there was good sensitivity,specificity, PV-, PV+, and larger AUC(sensitivity91%, specificity100%,PV-87.5%, PV+100%,AUC0.99).Conclusions：: GY-6620at home is valuable in diagnosing OSAS, andholter monitoring of OSAS is applicable. Part2The relation among coronary artery disease, pulse wave velocity andObstructive sleep apnea syndromeObjective：To investigate the correlation among coronary arterydisease (CAD),pulse wave velocity(PWV) and the sleep apneasyndrome(SAS),and possible mechanism. Methods: PWV was measured in135patients who underwent coronaryangiographic examination (CAG) and performed home polysomnographymonitoring because CAD or chest pain， blood glucose c-reactiveprotein were investigated, then result was analyzed from January2012tomarch2012.Results:(1) Angiographically identified stenosis>50%in the majorcoronary vessel were used to classify patients as havingsingle-(15patients),double-(19patients),or many-(41patients) vesseldisease,63patients have moderate or severe OSAS;(2)Incidence of CADand Gensini score in group of moderate or severe OSAS are high thanin group of the rest of moderate or severe OSAS (incidence of CAD66.6%VS45.8%,P<0.05;Gensiniscore:13.53±16.91VS28.98±23.87, P<0.05), Incidence of moderate or severe OSAS has significant differenceamong group of single vessel disease, group of double-vessel disease andgroup of many-vessel disease, incidence of moderate or severe OSASwas found positively correlation with number of coronary vessel lesions(R=0.376,p<0.05);(3)PWV in group of moderate or severe OSAS was highthan in group of the rest of moderate or severe OSAS （PWV：1349.97±222.58VS1615.52±190.19,P<0.01）,PWV correlate positively withAHI(R=0.40,P<0.01);(4) PWV has significant difference between group ofCAD and group no-CAD(PWV：1621.24±190.31VS1393.05±131.50，P=0.00),among group of single vessel disease, group of double-vesseldisease and group of many-vessel disease(PWV:1476.2±163.52VS1545.63±174.3,1545.63±174.3VS1680.10±215.72,1476.2±163.52VS1680.10±215.72),PWV correlate positively with number of coronary vessellesions (R=0.368,P<0.01),with Gensini score(R=0.6，P<0.01);Conclusions: OSAS is a dangerous factor for CAD and PWV in group of moderate or severe OSAS was high than in group of the rest of moderateor severe OSAS,PWV was marker of arteriosclerosis, so arteriosclerosismay be a mechanism of OSAS resulting in CAD.