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(Stroke. 2002;33:1782.)
© 2002 American Heart Association, Inc.

Original Contributions

Carotid Artery Wall Thickness in Patients With Obstructive Sleep Apnea Syndrome

Mauro Silvestrini, MD; Barbara Rizzato, MD; Fabio Placidi, PhD; Roberto Baruffaldi, MD; Alberto Bianconi, MD Marina Diomedi, PhD

From the Neurological Clinic, University of Ancona (M.S., R.B., A.B.); IRCCS "S Lucia," Rome (M.S.); and Neurological Clinic, "Tor Vergata" University of Rome, Rome (B.R., F.P., M.D.), Italy.

Correspondence to Professor Mauro Silvestrini, Clinica Neurologica, Università degli Studi di Ancona, Azienda Ospedaliera Umberto I, Via Conca 1, 60020 Torrette di Ancona (AN), Italy. E-mail masilvestrini@ libero.it

Background and Purpose— Epidemiological studies have suggested a pathophysiological link between sleep apnea syndrome and cerebrovascular diseases. The mechanism by which sleep disturbance can affect the predisposition to developing stroke is not clear. The aim of this study was to investigate whether patients with obstructive sleep apnea syndrome have an increase in atherosclerosis indicators at the carotid artery level.

Methods— We included 23 male patients with severe obstructive sleep apnea syndrome (respiratory disturbance index >30). Intima-media thickness and the presence of steno-occlusive lesions in the common carotid arteries were investigated with B-mode high-resolution ultrasonography. Results of the ultrasonographic examination were compared with those of a group of 23 subjects without obstructive sleep apnea syndrome who were matched for age and comorbid factors.

Results— The intima-media thickness of the common carotid arteries of patients with obstructive sleep apnea syndrome was significantly higher (P<0.0001) than that of control subjects (1.429±0.34 versus 0.976±0.17 mm).

Conclusions— Results of the present study show that carotid wall thickness is increased in patients with severe sleep apnea syndrome. There is strong evidence that an increase in the thickness of the carotid artery wall is a valid marker of the risk of stroke. For this reason, our finding seems to further strengthen the hypothesis that patients with obstructive sleep apnea syndrome are at risk of developing cerebrovascular diseases regardless of the association with other vascular risk factors.

Key Words: atherosclerosis • carotid arteries • risk factors • sleep apnea, obstructive • ultrasonography, Doppler, duplex

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